Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
KELLY LORAINE DAUER PHAM, MD
Active Sole ProprietorKELLY LORAINE DAUER PHAM, MD is a Pediatric Rehabilitation Medicine healthcare provider located in VIENNA, Virginia. NPI 1417274689 is currently active in the NPPES registry. Verify at CMS.
Pediatric Rehabilitation Medicine · VIENNA, VA
Registration Details
- NPI Number
- 1417274689
- Provider Type
- Individual
- Gender
- Female
- NPI Issued
- Apr 28, 2010 (16.333622985101 yrs)
- Last Updated
- Apr 13, 2022
- Licenses
-
0101273373 (VA)185401 (DC)FE60464961 (WA)0101273373 (VA)
- Sole Proprietor
- Yes
Practice Information
- Address
-
8230 BOONE BLVD STE 170VIENNA, VA, 221822621Browse VA providers · Browse ZIP 22182
- Phone
- 5713102502
- Fax
- 5714130290
- Primary Specialty
-
Pediatric Rehabilitation Medicine
2081P0010X
- Additional Specialty
- Physical Medicine & Rehabilitation
- Additional Specialty
- Pediatric Rehabilitation Medicine
- Additional Specialty
- Student (Health Education/Training)
- Additional Specialty
- Pediatric Rehabilitation Medicine
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.