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NPI Code Detail

MEDICARE: DR. JUDY HA PHAM MD

MEDICARE: DR. JUDY HA PHAM 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
1207R00000XInternal Medicine Physician4301507866MI

General Provider Information

NPI Number : 1801449616
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JUDY HA PHAM MD
Provider Business Mailing Address
First Line : 13210 E JEFFERSON AVE
Second Line :
City : DETROIT
State : MI
Zip : 48215-2704
Country : US
Telephone Number : 313-335-3444
Fax Number : 313-484-4998
Provider Business Practice Location Address
First Line : 13210 E JEFFERSON AVE
Second Line :
City : DETROIT
State : MI
Zip : 48215-2704
Country : US
Telephone Number : 313-335-3444
Fax Number : 313-484-4998
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/20/2019
Last Update Date : 10/07/2022

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