Provider Demographics
NPI:1043316680
Name:NGUYEN, KHANGHY D (DO)
Entity Type:Individual
Prefix:DR
First Name:KHANGHY
Middle Name:D
Last Name:NGUYEN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:DR
Other - First Name:KHANG
Other - Middle Name:HY DUY
Other - Last Name:NGUYEN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DO
Mailing Address - Street 1:PO BOX 13008
Mailing Address - Street 2:
Mailing Address - City:LANSING
Mailing Address - State:MI
Mailing Address - Zip Code:48901-3008
Mailing Address - Country:US
Mailing Address - Phone:517-364-6253
Mailing Address - Fax:517-364-6208
Practice Address - Street 1:800 E COLUMBIA ST
Practice Address - Street 2:
Practice Address - City:MASON
Practice Address - State:MI
Practice Address - Zip Code:48854-1381
Practice Address - Country:US
Practice Address - Phone:517-244-8900
Practice Address - Fax:517-244-8911
Is Sole Proprietor?:No
Enumeration Date:2006-09-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5101016035208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery