Provider Demographics
NPI:1073500039
Name:NGUYEN, HARRY P (MD)
Entity Type:Individual
Prefix:DR
First Name:HARRY
Middle Name:P
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 1:171 WHIELDON LN
Mailing Address - Street 2:
Mailing Address - City:WORTHINGTON
Mailing Address - State:OH
Mailing Address - Zip Code:43085-2940
Mailing Address - Country:US
Mailing Address - Phone:614-707-7359
Mailing Address - Fax:
Practice Address - Street 1:2715 SAWBURY BLVD.
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43235
Practice Address - Country:US
Practice Address - Phone:614-726-5343
Practice Address - Fax:614-766-5264
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-04
Last Update Date:2012-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35 044048N207P00000X
OH35-044048207QA0401X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QA0401XAllopathic & Osteopathic PhysiciansFamily MedicineAddiction Medicine
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH311216961 00OtherBWC
OH311216961 00OtherBWC
D31260Medicare UPIN