Doctor Name: | DR. OANH XUAN DAM |
NPI Number: | 1841499761 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | M.D. |
License Number: | 040894 |
Business Practice Address: | 4487 Jonesboro Rd Forest Park, GA - 302974316 |
Business Phone Number: | 4043668822 |
Business Fax Number: | 4043668824 |
Mailing Address: | 4487 Jonesboro Rd, FOREST PARK |
State: | GA |
Postal Code: | 302974316 |
Phone Number: | 4043668822 |
Fax Number: | 4043668824 |
NPI Enumeration Date: | 07/11/2007 |
NPI Last Update Date: | 07/12/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | 040894 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | GA |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |