Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Q00000X | Family Doctor | 0102203751 | VA |
N | 207QH0002X | Family Doctor - Hospice and Palliative Medicine | 0102203751 | VA |
NPI | 1346561313 |
---|---|
Provider Name | Dr. Elizabeth Vu Phan |
First Address | Falls Church, VA 22042-1206 |
Second Address | Falls Church, VA 22042-1206 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/06/2010 |
Last Update Date | 22/07/2021 |