Provider Demographics
NPI:1336565225
Name:PHAM, CHRISTOPHER KHANH THIEN (DO)
Entity Type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:KHANH THIEN
Last Name:PHAM
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:816 WALDEN CHASE LN
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:GA
Mailing Address - Zip Code:31909-1763
Mailing Address - Country:US
Mailing Address - Phone:240-687-8487
Mailing Address - Fax:706-544-4040
Practice Address - Street 1:490 E NORTH AVE STE 309
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15212-4740
Practice Address - Country:US
Practice Address - Phone:412-442-2522
Practice Address - Fax:412-442-2524
Is Sole Proprietor?:Yes
Enumeration Date:2014-03-15
Last Update Date:2023-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0102203639207Q00000X
PAOS022982207RS0012X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RS0012XAllopathic & Osteopathic PhysiciansInternal MedicineSleep Medicine
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine