Provider Demographics
NPI:1194233007
Name:PHAM, TAM (PHARMD)
Entity type:Individual
Prefix:DR
First Name:TAM
Middle Name:
Last Name:PHAM
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:700 CRAIGHEAD ST STE 103
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37204-2254
Mailing Address - Country:US
Mailing Address - Phone:615-730-6439
Mailing Address - Fax:615-249-5155
Practice Address - Street 1:700 CRAIGHEAD ST STE 103
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37204-2254
Practice Address - Country:US
Practice Address - Phone:615-730-6439
Practice Address - Fax:615-249-5155
Is Sole Proprietor?:No
Enumeration Date:2018-01-12
Last Update Date:2020-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN43572183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist