Phan H Thanh M D P C

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

4301 035554 Issued in MI

Legal business name

PHAN H THANH M D P C

Practice address

4000 Highland Rd
Suite 110
Waterford, MI 48328-2167

Phone

(248) 681-1025

Fax

(248) 681-1533

NPI assigned

Mar 4, 2008

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Thanh Huu Phan, M.D.

Title

President

Phone

(248) 681-1025

Specialties & licenses 2

Addresses

Other identifiers 2

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1204588800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1207267200000",
    "number": "1063682219",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4000 HIGHLAND RD",
            "address_2": "SUITE 110",
            "city": "WATERFORD",
            "state": "MI",
            "postal_code": "483282167",
            "telephone_number": "248-681-1025",
            "fax_number": "248-681-1533"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4000 HIGHLAND RD",
            "address_2": "SUITE 110",
            "city": "WATERFORD",
            "state": "MI",
            "postal_code": "483282167",
            "telephone_number": "248-681-1025",
            "fax_number": "248-681-1533"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHAN H THANH M D P C",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-04",
        "last_updated": "2008-04-04",
        "status": "A",
        "authorized_official_last_name": "PHAN",
        "authorized_official_first_name": "THANH",
        "authorized_official_middle_name": "HUU",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "248-681-1025",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery",
            "state": "MI",
            "license": "4301 035554",
            "primary": true
        },
        {
            "code": "2086S0129X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery, Vascular Surgery",
            "state": "MI",
            "license": "4301 035554",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSM/BCN",
            "identifier": "0206316622",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HAP",
            "identifier": "87199A",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Olinda Patricia Perry
• Andrea Perteet
• Sadeer Peter, M.D
• Lyn Peyton, PHD
• Julie Christine Pfeifle, PA-C
• Katherine Phelps
• John Philipose
• Jennifer Phillips, OT
• Physicians Resources Network, PC
• Physio4Relief PC

• Surgery Physician in Waterford, MI
• Providers in Waterford, MI by specialty
• Surgery Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.