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Individual

DR. THANH-HA PHAM

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
1510 N 28TH ST, SUITE 308, RICHMOND, VA 23223-5311
(804) 644-1665
(804) 644-5285
Mailing address
1510 N 28TH ST, SUITE 308, RICHMOND, VA 23223-5311
(804) 644-1665
(804) 644-5285

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
0101244710
VA
207R00000X
Internal Medicine Physician
22163
WV

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
001788654
BLUE CROSS BLUE SHIELD
WV
05
3810004094
WV
01
C06695
GROUP PTAN
VA
Enumeration date
09/20/2006
Last updated
12/29/2009
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