Julia Cecilia Santoso Pham
MOHS-Micrographic Surgeon
515 Fairmount Ave Suite 350
Towson
, Maryland 21286-5466
Julia Cecilia Santoso Pham
MOHS-Micrographic Surgeon
515 Fairmount Ave Suite 350
Towson
, Maryland 21286-5466
(410) 494-1361
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About
Features
Specialties
- MOHS-Micrographic Surgeon
Languages spoken
- English
Location
First Address
- Julia Cecilia Santoso Pham
- 515 Fairmount Ave Ste 350
- Towson, MD
- Zip : 21286-5466
- Fax : (410) 494-1361
- Phone : (410) 494-1355
Second Address
- Julia Cecilia Santoso Pham
- 515 Fairmount Ave Suite 350
- Towson, MD
- Zip : 21286-5466
- Phone : (410) 494-1340
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 207ND0101X | MOHS-Micrographic Surgeon | H59469 | MD |
National Provider Identifier
| NPI | 1144265414 |
|---|---|
| Provider Name | Julia Cecilia Santoso Pham |
| First Address | Towson, MD 21286-5466 |
| Second Address | Towson, MD 21286-5466 |
| Gender | F |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 19/06/2006 |
| Last Update Date | 04/12/2020 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| F19219 | (02) | MD |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.