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Individual

ALEXANDRIA T PHAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
9200 W WISCONSIN AVE, MILWAUKEE, WI 53226-3522
(414) 805-0505
(414) 955-0231
Mailing address
9200 W WISCONSIN AVE, MILWAUKEE, WI 53226-3522
(414) 805-0505
(414) 955-0231

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
L3069
TX
207RH0003X
Hematology & Oncology Physician
23373-875
WI
207RH0003X
Hematology & Oncology Physician
L3069
TX
207RX0202X
Medical Oncology Physician
23373-875
WI
207RX0202X
Medical Oncology Physician
Primary
L3069
TX
207RX0202X
Medical Oncology Physician
MD2016-0653
NM

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
147345602
TX
05
147345603
TX
01
1821016148
BLUE CROSS BLUE SHIELD
TX
05
1821016148
WI
01
8EE349
BLUE CROSS BLUE SHIELD
TX
01
8J1932
BCBS
TX
01
P01186458
RR MEDICARE
TX
Enumeration date
07/17/2006
Last updated
01/20/2023
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