Individual
DR. DAVID PHUNG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4411 THE 25 WAY NE, STE 150, ALBUQUERQUE, NM 87109-5888
(505) 332-6900
(505) 332-6921
Mailing address
4411 THE 25 WAY NE, STE 150, ALBUQUERQUE, NM 87109-5888
(505) 332-6900
(505) 332-6921
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
2002-0090
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2258272
MEDICARE GROUP
NM
05
—
45138
—
NM
05
—
52713
—
NM
01
—
600521102
MEDICARE IDTF
NM
05
—
66503566
—
NM
01
—
700521102
MEDICARE GROUP
NM
01
—
800521126
MEDICARE IDTF
NM
05
—
L0634
—
NM
Enumeration date
06/09/2005
Last updated
03/12/2014
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