| Trung Hoa Pham, Md, Llc | |
|
5415 Old Court Rd Ste 102 Randallstown MD 21133-5103 | |
| (410) 701-4600 | |
| (410) 701-4481 |
| Full Name | Trung Hoa Pham, Md, Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 5415 Old Court Rd Ste 102, Randallstown, Maryland |
| Authorized Official Name and Position | Trung Hoa Pham (PRESIDENT) |
| Authorized Official Contact | 4436048928 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Trung Hoa Pham, Md, Llc 6509 Early Lily Row Columbia MD 21044-6057 Ph: (410) 701-4600 | Trung Hoa Pham, Md, Llc 5415 Old Court Rd Ste 102 Randallstown MD 21133-5103 Ph: (410) 701-4600 |
| NPI Number | 1366579161 |
|---|---|
| Provider Enumeration Date | 02/27/2007 |
| Last Update Date | 04/13/2011 |
| Medicare PECOS PAC ID | 8527168111 |
|---|---|
| Medicare Enrollment ID | O20070711000863 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1366579161 | NPI | - | NPPES |
| 484802100 | Medicaid | MD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | D0047704 (Maryland) | Primary |
| Provider Name | Trung H Pham |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1669491999 PECOS PAC ID: 5698875284 Enrollment ID: I20070711000878 |
| Provider Name | Jeffrey M Kufel |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1437469723 PECOS PAC ID: 7315259017 Enrollment ID: I20150709001167 |
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