Provider Demographics
NPI:1730117359
Name:PHAM, NAMTRAN H (MD)
Entity Type:Individual
Prefix:DR
First Name:NAMTRAN
Middle Name:H
Last Name:PHAM
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:3801 N FAIRFAX DRIVE
Mailing Address - Street 2:STE 74
Mailing Address - City:ARLINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:22203
Mailing Address - Country:US
Mailing Address - Phone:703-528-3910
Mailing Address - Fax:703-528-4367
Practice Address - Street 1:3801 N FAIRFAX DRIVE
Practice Address - Street 2:STE 74
Practice Address - City:ARLINGTON
Practice Address - State:VA
Practice Address - Zip Code:22203
Practice Address - Country:US
Practice Address - Phone:703-528-3910
Practice Address - Fax:703-528-4367
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-30
Last Update Date:2023-03-07
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
VA0101053654207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
247570OtherANTHEM BCBS
2563678OtherUNITED HEALTHCARE
7580719OtherAETNA
6804019OtherCIGNA
732437OtherNCPPO
5666624OtherMAILHANDERSFIRSTHEALTH
9399465OtherPHCS
VABP9352105OtherDEA
732437OtherNCPPO