Provider Demographics
NPI:1023332707
Name:PHAM, ANSON LE (MD)
Entity type:Individual
Prefix:
First Name:ANSON
Middle Name:LE
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 1:10432 PATRIOT HWY
Mailing Address - Street 2:
Mailing Address - City:FREDERICKSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22408-2628
Mailing Address - Country:US
Mailing Address - Phone:804-675-6746
Mailing Address - Fax:
Practice Address - Street 1:10432 PATRIOT HWY
Practice Address - Street 2:
Practice Address - City:FREDERICKSBURG
Practice Address - State:VA
Practice Address - Zip Code:22408-2628
Practice Address - Country:US
Practice Address - Phone:804-675-6746
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-03-24
Last Update Date:2025-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101254119207RH0002X, 207RG0300X, 207R00000X
SC38154207RH0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RH0002XAllopathic & Osteopathic PhysiciansInternal MedicineHospice and Palliative Medicine
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine