Healthcare Provider Details

I. General information

NPI: 1932582467
Provider Name (Legal Business Name): ANH K PHAM M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: KHOA PHAM MD

II. Dates (important events)

Enumeration Date: 07/01/2015
Last Update Date: 03/12/2025
Certification Date: 03/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2240 COLISEUM DR STE D
HAMPTON VA
23666-5903
US

IV. Provider business mailing address

1706 TODDS LN # 310
HAMPTON VA
23666-3123
US

V. Phone/Fax

Practice location:
  • Phone: 888-321-7170
  • Fax:
Mailing address:
  • Phone: 888-321-7170
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207ND0900X
TaxonomyDermatopathology Physician
License Number0101269065
License Number StateVA
# 2
Primary TaxonomyY
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License Number0101269065
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: