Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Dr. Ngoc Bao Phan, DO

Individual provider Internal Medicine Physician · NPI 1215299086

Dr. Ngoc Bao Phan, DO is an Internal Medicine in Lilburn, Georgia. Qualified in 2012, 14 years ago. Works from 2 locations and accepts Medicare assignment. Licensed in Georgia.

Years since qualifying
14
Licensed in
GA
In the registry since
2012
What do these letters mean?
DO — Doctor of Osteopathic Medicine
A fully licensed physician, trained like an MD with additional musculoskeletal training. Equivalent practice rights in all 50 states.

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Practice location Address checks out

625 Beaver Ruin Rd NW Ste E
Lilburn, GA 30047-3407
Phone: (678) 369-9399
Fax: (833) 464-3867
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 302 Satellite Blvd Ne Ste 109&110, Suwanee, GA 30024-7181 — (678) 369-9399

Specialties & licences

Internal Medicine Physician (primary) Taxonomy 207R00000X · Licence 73360 (GA)

Record details

NPI number1215299086
Entity typeIndividual (Type 1)
GenderFemale
Credentials DO
Sole proprietorNo
NPI enumeratedJune 8, 2012
Last updated in NPPESOctober 28, 2024
Certification dateOctober 28, 2024
Mailing address625 Beaver Ruin Rd Nw Ste E, Lilburn, GA 30047-3407

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyINTERNAL MEDICINE
Medical schoolOTHER
Graduated 2012 (14 years in practice)
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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