Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 1223G0001X | General Practice | 8285 | VA |
N | 213EG0000X | General Practice | 8285 | VA |
Y | 1223P0700X | Prosthodontist | 8285 | VA |
NPI | 1033281803 |
---|---|
Provider Name | Dr. Anh-Minh Phan |
First Address | Alexandria, VA 22314-2771 |
Second Address | Alexandria, VA 22314-2771 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 15/11/2006 |
Last Update Date | 08/09/2020 |