Provider Demographics
NPI:1003083981
Name:PHAM, HUONG DIEN (MD)
Entity Type:Individual
Prefix:
First Name:HUONG
Middle Name:DIEN
Last Name:PHAM
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4626 ALCEE FORTIER BLVD
Mailing Address - Street 2:STE D
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70129-2130
Mailing Address - Country:US
Mailing Address - Phone:504-324-8760
Mailing Address - Fax:504-324-9074
Practice Address - Street 1:4626 ALCEE FORTIER BLVD D
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70129-2130
Practice Address - Country:US
Practice Address - Phone:504-324-8760
Practice Address - Fax:504-324-9074
Is Sole Proprietor?:No
Enumeration Date:2008-05-10
Last Update Date:2016-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LABU3479335-181207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology