Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208200000X | Surgeon | MD61096401 | WA |
N | 208600000X | Surgeon | MD61096401 | WA |
Y | 2086S0129X | Vascular Surgeon | MD61096401 | WA |
NPI | 1003164112 |
---|---|
Provider Name | Xuan-Binh D Pham |
First Address | Salt Lake City, UT 84125-0608 |
Second Address | Seattle, WA 98122-4396 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/08/2012 |
Last Update Date | 30/09/2020 |