Provider Demographics
NPI:1013570365
Name:NGUYEN, NATASHA KRISTINE (MD)
Entity Type:Individual
Prefix:MS
First Name:NATASHA
Middle Name:KRISTINE
Last Name:NGUYEN
Suffix:
Gender:F
Credentials:MD
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Other - Middle Name:
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Mailing Address - Street 1:1540 E HOSPITAL DR SPC 5718
Mailing Address - Street 2:
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48109-4000
Mailing Address - Country:US
Mailing Address - Phone:734-936-9777
Mailing Address - Fax:734-936-6897
Practice Address - Street 1:1540 E HOSPITAL DR SPC 5718
Practice Address - Street 2:
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48109-4000
Practice Address - Country:US
Practice Address - Phone:734-936-9777
Practice Address - Fax:734-936-6897
Is Sole Proprietor?:No
Enumeration Date:2019-04-22
Last Update Date:2022-07-13
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI430150664207QA0000X
MI4301506664207QA0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QA0000XAllopathic & Osteopathic PhysiciansFamily MedicineAdolescent Medicine