Provider Demographics
NPI:1932582467
Name:PHAM, ANH K (MD)
Entity Type:Individual
Prefix:DR
First Name:ANH
Middle Name:K
Last Name:PHAM
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:KHOA
Other - Middle Name:
Other - Last Name:PHAM
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:207 BULIFANTS BLVD STE C
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:23188-5732
Mailing Address - Country:US
Mailing Address - Phone:757-622-6315
Mailing Address - Fax:757-253-2223
Practice Address - Street 1:207 BULIFANTS BLVD STE C
Practice Address - Street 2:
Practice Address - City:WILLIAMSBURG
Practice Address - State:VA
Practice Address - Zip Code:23188-5732
Practice Address - Country:US
Practice Address - Phone:757-622-6315
Practice Address - Fax:757-253-2223
Is Sole Proprietor?:No
Enumeration Date:2015-07-01
Last Update Date:2023-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101269065207N00000X, 207ND0900X
IL036.148975207ND0900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ND0900XAllopathic & Osteopathic PhysiciansDermatologyDermatopathology
No207N00000XAllopathic & Osteopathic PhysiciansDermatology