Provider Demographics
NPI:1053638858
Name:VO, NGUYEN (MD)
Entity Type:Individual
Prefix:
First Name:NGUYEN
Middle Name:
Last Name:VO
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 1:100 MEDICAL CENTER WAY DEPT OF
Mailing Address - Street 2:
Mailing Address - City:SOMERS POINT
Mailing Address - State:NJ
Mailing Address - Zip Code:08244-2300
Mailing Address - Country:US
Mailing Address - Phone:609-653-3500
Mailing Address - Fax:609-653-3967
Practice Address - Street 1:100 MEDICAL CENTER WAY DEPT OF
Practice Address - Street 2:
Practice Address - City:SOMERS POINT
Practice Address - State:NJ
Practice Address - Zip Code:08244-2300
Practice Address - Country:US
Practice Address - Phone:609-653-3500
Practice Address - Fax:609-653-3967
Is Sole Proprietor?:No
Enumeration Date:2010-05-03
Last Update Date:2019-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD450560207ZC0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZC0500XAllopathic & Osteopathic PhysiciansPathologyCytopathology