Individual
NICK M PHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
6408 SEVEN CORNERS PL STE F, FALLS CHURCH, VA 22044-2011
(703) 533-7673
Mailing address
PO BOX 2782, FAIRFAX, VA 22031-0782
(703) 533-7673
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
0202205955
VA
207R00000X
Internal Medicine Physician
Primary
0101244284
VA
Other
Enumeration date
09/18/2007
Last updated
02/02/2012
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