Provider Demographics
NPI:1689848574
Name:DUC M PHAM, MD PC
Entity Type:Organization
Organization Name:DUC M PHAM, MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:DUC
Authorized Official - Middle Name:M
Authorized Official - Last Name:PHAM
Authorized Official - Suffix:
Authorized Official - Credentials:MD, PC
Authorized Official - Phone:480-961-9299
Mailing Address - Street 1:3320 N. MILLER ROAD
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85251-6430
Mailing Address - Country:US
Mailing Address - Phone:480-961-9299
Mailing Address - Fax:480-961-1802
Practice Address - Street 1:3320 N. MILLER ROAD
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85251-6430
Practice Address - Country:US
Practice Address - Phone:480-961-9299
Practice Address - Fax:480-961-1802
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-22
Last Update Date:2023-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ31116174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZZ74933Medicare PIN