Provider Demographics
NPI:1265019426
Name:PHAM, DANIEL QUOC BAO (MD)
Entity type:Individual
Prefix:
First Name:DANIEL
Middle Name:QUOC BAO
Last Name:PHAM
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8025 BURNETT WOMACK BUILDING CAMPUS BOX #7172 UNC-CH
Mailing Address - Street 2:
Mailing Address - City:CHAPEL HILL
Mailing Address - State:NC
Mailing Address - Zip Code:27599-7170
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:100 EASTOWNE DR
Practice Address - Street 2:
Practice Address - City:CHAPEL HILL
Practice Address - State:NC
Practice Address - Zip Code:27514-2286
Practice Address - Country:US
Practice Address - Phone:984-974-2950
Practice Address - Fax:984-974-2924
Is Sole Proprietor?:No
Enumeration Date:2021-03-25
Last Update Date:2024-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2024-01677207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine