Provider Demographics
NPI:1346561313
Name:PHAN, ELIZABETH VU (DO)
Entity Type:Individual
Prefix:DR
First Name:ELIZABETH
Middle Name:VU
Last Name:PHAN
Suffix:
Gender:F
Credentials:DO
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Mailing Address - Street 1:2900 TELESTAR CT
Mailing Address - Street 2:
Mailing Address - City:FALLS CHURCH
Mailing Address - State:VA
Mailing Address - Zip Code:22042-1206
Mailing Address - Country:US
Mailing Address - Phone:703-531-2384
Mailing Address - Fax:703-852-7389
Practice Address - Street 1:2900 TELESTAR CT
Practice Address - Street 2:
Practice Address - City:FALLS CHURCH
Practice Address - State:VA
Practice Address - Zip Code:22042-1206
Practice Address - Country:US
Practice Address - Phone:703-531-2384
Practice Address - Fax:703-852-7389
Is Sole Proprietor?:No
Enumeration Date:2010-06-14
Last Update Date:2021-07-22
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
VA0102203751207QH0002X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207QH0002XAllopathic & Osteopathic PhysiciansFamily MedicineHospice and Palliative Medicine