Provider Demographics
NPI:1043220791
Name:LIEM, PHAM HIEU (MD)
Entity Type:Individual
Prefix:DR
First Name:PHAM
Middle Name:HIEU
Last Name:LIEM
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:343 VALLEY CLUB CIR
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72212-2900
Mailing Address - Country:US
Mailing Address - Phone:501-227-0947
Mailing Address - Fax:501-686-5884
Practice Address - Street 1:4301 W MARKHAM ST
Practice Address - Street 2:748
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72205-7101
Practice Address - Country:US
Practice Address - Phone:501-686-5944
Practice Address - Fax:501-686-5884
Is Sole Proprietor?:No
Enumeration Date:2006-08-08
Last Update Date:2008-03-18
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
ARR2702207QG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QG0300XAllopathic & Osteopathic PhysiciansFamily MedicineGeriatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
ARR2702OtherTRICARE
AR53973OtherBCBS
AR11878000000OtherQUALCHOICE
ARD84318Medicare UPIN
AR53973OtherBCBS