Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | R73749 | AZ |
N | 111NI0900X | Internist | R73749 | AZ |
Y | 207RR0500X | Rheumatology | 49549 | AZ |
N | 207RR0500X | Rheumatology | 60555 | MN |
NPI | 1023453479 |
---|---|
Provider Name | Dr. Michael Pham |
First Address | Scottsdale, AZ 85259-5452 |
Second Address | Scottsdale, AZ 85259-5452 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/04/2013 |
Last Update Date | 03/09/2020 |