Provider Demographics
NPI:1023018090
Name:NGUYEN, CHUONG H (MD)
Entity Type:Individual
Prefix:
First Name:CHUONG
Middle Name:H
Last Name:NGUYEN
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 1:5045 E LEMANS ST
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70129-1226
Mailing Address - Country:US
Mailing Address - Phone:504-812-3981
Mailing Address - Fax:
Practice Address - Street 1:4626 ALCEE FORTIER BLVD STE D
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70129-2130
Practice Address - Country:US
Practice Address - Phone:504-812-3981
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-07-29
Last Update Date:2017-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA14277R207R00000X
LAMD.14277R208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA4J486CW35OtherMEDICARE PROVIDER NUMBER
LA1478270Medicaid
LA4J486CW35OtherMEDICARE PROVIDER NUMBER