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NPI Code Detail

MEDICARE: ROBERT PHAM PH.D MD

MEDICARE:   ROBERT  PHAM  PH.D MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207RG0100XGastroenterology Physician1010026780NV

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
11010026780OTHERNVNEVADA LICENSE

General Provider Information

NPI Number : 1740596188
Entity Type Code : Individual
Provider Name (Legal Business Name) : ROBERT PHAM PH.D MD
Provider Business Mailing Address
First Line : 848 N RAINBOW BLVD
Second Line : #2531
City : LAS VEGAS
State : NV
Zip : 89107-1103
Country : US
Telephone Number : 702-942-7344
Fax Number : 954-543-7183
Provider Business Practice Location Address
First Line : 848 N RAINBOW BLVD
Second Line : #2531
City : LAS VEGAS
State : NV
Zip : 89107-1103
Country : US
Telephone Number : 702-942-7344
Fax Number : 954-543-7183
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/24/2010
Last Update Date : 08/24/2010

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Directions to “ ROBERT PHAM PH.D MD” Practice Location

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