Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207T00000X | Neurosurgeon | OS9899 | FL |
NPI | 1043399819 |
---|---|
Provider Name | Dr. Christopher Joseph Pham |
First Address | Naples, FL 34119-8088 |
Second Address | Naples, FL 34119-8088 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/11/2006 |
Last Update Date | 09/08/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
DR401A | (02) | FL |