Individual
QUANG PHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4725 N. FEDERAL HIGHWAY, FORT LAUDERDALE, FL 33308-4603
(954) 771-8000
(954) 776-3270
Mailing address
PO BOX 551420, FORT LAUDERDALE, FL 33355-1420
(800) 243-3839
(855) 851-4405
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
309169
NY
207L00000X
Anesthesiology Physician
MD036338
DC
207L00000X
Anesthesiology Physician
ME98877
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000731400
—
FL
01
—
68782
BLUE CROSS BLUE SHIELD
FL
Enumeration date
10/11/2006
Last updated
09/27/2021
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