Provider Demographics
NPI:1437344603
Name:PHAM, ANGELA OANH (MD)
Entity Type:Individual
Prefix:
First Name:ANGELA
Middle Name:OANH
Last Name:PHAM
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:ANGELA
Other - Middle Name:OANH
Other - Last Name:MCMILLEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:100 PROFESSIONAL PL
Mailing Address - Street 2:STE 204
Mailing Address - City:CARROLLTON
Mailing Address - State:GA
Mailing Address - Zip Code:30117-3802
Mailing Address - Country:US
Mailing Address - Phone:770-812-5905
Mailing Address - Fax:770-838-8563
Practice Address - Street 1:905 DIXIE ST
Practice Address - Street 2:
Practice Address - City:CARROLLTON
Practice Address - State:GA
Practice Address - Zip Code:30117-4417
Practice Address - Country:US
Practice Address - Phone:770-812-5831
Practice Address - Fax:770-812-5832
Is Sole Proprietor?:No
Enumeration Date:2007-09-11
Last Update Date:2018-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA62591207RR0500X
GA062591207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology