Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RA0001X | Advanced Heart Failure and Transplant Cardiologist | 69643-20 | WI |
Y | 207RC0000X | Internist - Cardiovascular Disease | 69643-20 | WI |
NPI | 1023344199 |
---|---|
Provider Name | Dr. David Dung Pham |
First Address | Middleton, WI 53562-5531 |
Second Address | Madison, WI 53792 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/10/2009 |
Last Update Date | 07/01/2021 |