Provider Demographics
NPI:1043371420
Name:NGUYEN, CHRIS BRIAN (MD)
Entity Type:Individual
Prefix:
First Name:CHRIS
Middle Name:BRIAN
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 1:124 BERKSHIRE AVE
Mailing Address - Street 2:
Mailing Address - City:BELMONT
Mailing Address - State:NC
Mailing Address - Zip Code:28012-3882
Mailing Address - Country:US
Mailing Address - Phone:704-915-9579
Mailing Address - Fax:
Practice Address - Street 1:2525 COURT DR
Practice Address - Street 2:DEPARTMENT OF PATHOLOGY, GASTON MEMORIAL HOSPITAL
Practice Address - City:GASTONIA
Practice Address - State:NC
Practice Address - Zip Code:28054-2140
Practice Address - Country:US
Practice Address - Phone:704-915-9579
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-12
Last Update Date:2014-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLTRN10371207ZC0500X
NC2006-00130207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
No207ZC0500XAllopathic & Osteopathic PhysiciansPathologyCytopathology