DR. TRUC THANH PHAM (NPI# 1003808312) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1003808312 |
| Entity Type | Individual |
| Full Name | DR. TRUC THANH PHAM |
| Credential | M.D. |
| Practice Address |
3985 Steve Reynolds Blvd Suite K 102 Norcross GA 30093-3035 |
| Practice Telephone | 6783670390 |
| Practice Fax Number | 6782453391 |
| Mailing Telephone | 6783670390 |
| Mailing Fax Number | 6782453391 |
| Enumeration Date | 2005-08-22 |
| Last Update Date | 2008-05-16 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | 049706 | GA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | 844204821B | 05 | |
| GA | 844204821A | 05 | |
| GA | BLUE CROSS BLUE SHIELD ID | 52070574-001 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609320522 | Truc Pham | Registered Nurse | 2694 Winsley Pl, Duluth, GA 30097-3493 | 2016-08-09 |
| 1649553009 | Truc Minh Pham | Optometrist | 890 Dawsonville Hwy Ste A, Gainesville, GA 30501-2608 | 2011-09-22 |
| 1578645826 | Truc N Pham | Chiropractor | 639 Tully Rd Ste G, San Jose, CA 95111-1000 | 2006-10-19 |
| 1194988212 | Truc Thi Thu Pham | Hospitalist | 11110 Medical Campus Rd, Suite 1153, Hagerstown, MD 21742-6700 | 2008-07-09 |
| 1932237096 | Truc T Pham | Pathology | 13103 E Mansfield Ave, Incyte Diagnostics, Spokane Valley, WA 99216-1642 | 2007-03-01 |
| Street Address |
3985 STEVE REYNOLDS BLVD SUITE K 102 |
| City | NORCROSS |
| State | GA |
| Zip Code | 30093-3035 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740821644 | Thao Phuong Nguyen | Nurse Practitioner | 3985 Steve Reynolds Blvd, Norcross, GA 30093-3035 | 2019-10-01 |
| 1205367869 | Center for Rare Neurological Diseases | Clinic/Center | 3985 Steve Reynolds Blvd, Bldg O, Norcross, GA 30093-3035 | 2017-03-24 |
| 1376946517 | Emily Hill | Speech-Language Pathologist | 3985 Steve Reynolds Blvd, Buiding G, Norcross, GA 30093-3035 | 2014-10-02 |
| 1083022883 | Maya Simmons | Speech-Language Pathologist | 3985 Steve Reynolds Blvd, Building G, Norcross, GA 30093-3035 | 2014-07-24 |
| 1043625189 | Camille L Walton | Speech-Language Pathologist | 3985 Steve Reynolds Blvd, Suite G, Norcross, GA 30093-3035 | 2014-06-27 |
| 1326471574 | Dan Thanh Ngoc Vo | Physician Assistant | 3985 Steve Reynolds Blvd, Suite K102, Norcross, GA 30093-3035 | 2013-08-12 |
| 1538413661 | Mary Kavishe | Occupational Therapist | 3985 Steve Reynolds Blvd, Bld G, Norcross, GA 30093-3035 | 2012-10-26 |
| 1952668832 | Justine Darryl Louw | Physical Therapist | 3985 Steve Reynolds Blvd, Bldg G, Norcross, GA 30093-3035 | 2012-04-18 |
| 1588930218 | Emilie Erin Johnson | Occupational Therapist | 3985 Steve Reynolds Blvd, Bld G, Norcross, GA 30093-3035 | 2012-03-27 |
| 1528369733 | Cortney Jo Maholtz | Speech-Language Pathologist | 3985 Steve Reynolds Blvd, Bldg G, Norcross, GA 30093-3035 | 2010-11-04 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013517465 | Tequila Olivia Banks | Counselor | 8303 Dunleaf Arc Way Nw, Norcross, GA 30093 | 2020-10-27 |
| 1922643485 | Anthony Ervin | Case Manager/Care Coordinator | 6251 Smithpoint Dr. Bldg B, Peachtree Corners, GA 30093 | 2019-11-08 |
| 1164908885 | Marianne Altares | Speech-Language Pathologist | 1709 Oakbrook Lake Dr, Norcross, GA 30093 | 2018-07-16 |
| 1518480763 | Braces Now 14, LLC | Dentist | 4141 Steve Reynolds Blvd, Suite 2, Norcross, GA 30093 | 2017-07-19 |
| 1457802902 | Audrey Fernandes | Dentist | 4846 Jimmy Carter Blvd, Suite 203, Norcross, GA 30093 | 2016-10-19 |
| 1922456318 | Diana Lleras | Counselor | 6020 Dawson Bld Suite I, Norcross, GA 30093 | 2016-05-26 |
| 1376941500 | Katerine Velez | Counselor | 6020 Dawson Blvd., Siute I, Norcross, GA 30093 | 2014-12-22 |
| 1679979017 | Allison Ballay Donnelly | Speech-Language Pathologist | 1626 Jeurgens Ct., Norcross, GA 30093 | 2014-11-12 |
| 1588913701 | Sunrise Pharmacy | Pharmacy | 1235 Indian Trail Rd, Suite 200a, Norcross, GA 30093 | 2012-09-04 |
| 1821347154 | Shakirah Forde | Counselor | 1770 Indian Trail Lilburn Rd Ste 120, Norcross, GA 30093 | 2012-08-31 |
| Find all providers in zip 30093 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770131732 | Thao Hieu Pham | Family Medicine | 3985 Steve Reynolds Blvd Ste K102, Norcross, GA 30093-3099 | 2019-09-03 |
| 1831543081 | Abiola O Saibu | Family Medicine | 5300 Oakbrook Pkwy Ste 130, Norcross, GA 30093-2261 | 2016-04-13 |
| 1720367287 | Ibrahim Aliu Opaleye | Family Medicine | 5955 Jimmy Carter Blvd Ste 100, Norcross, GA 30071-4608 | 2011-08-15 |
| 1861722183 | Loma Clinic | Family Medicine | 6011 Western Hills Dr, 100, Norcross, GA 30071-3483 | 2010-01-08 |
| 1407025463 | Wilmer & Associates Group Inc. | Family Medicine | 1234 Beaver Ruin Rd, Suite 108, Norcross, GA 30093-3005 | 2008-02-25 |
| 1487840468 | Tesfaye Md | Family Medicine | 4045 Royal Pennon Ct, Norcross, GA 30092-2178 | 2007-09-24 |
| 1649318171 | Rafael A Nieves | Family Medicine | 5195 Jimmy Carter Blvd Ste 100, Norcross, GA 30093-1649 | 2007-02-05 |
| 1477607737 | Steven Ngoc Ha | Family Medicine | 5955 Jimmy Carter Blvd, Suite 40, Norcross, GA 30071-4641 | 2007-01-23 |
| 1629126677 | Julie M. Crusor | Family Medicine | 6010 Dawson Blvd, Suite A-2, Norcross, GA 30093-1225 | 2007-01-08 |
| 1184711517 | Magnolia Medical Clinic, P.C. | Family Medicine | 1235 Indian Trail Road, Suite 200, Norcross, GA 30093 | 2006-10-06 |
| Find all providers in NORCROSS | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.