Provider Demographics
NPI:1093200396
Name:DINH, ANNIE NGUYET (MD)
Entity Type:Individual
Prefix:DR
First Name:ANNIE
Middle Name:NGUYET
Last Name:DINH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:221 MICHIGAN ST NE STE 402
Mailing Address - Street 2:
Mailing Address - City:GRAND RAPIDS
Mailing Address - State:MI
Mailing Address - Zip Code:49503-2538
Mailing Address - Country:US
Mailing Address - Phone:616-391-1929
Mailing Address - Fax:616-391-3130
Practice Address - Street 1:221 MICHIGAN ST NE STE 402
Practice Address - Street 2:
Practice Address - City:GRAND RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49503-2538
Practice Address - Country:US
Practice Address - Phone:616-391-1929
Practice Address - Fax:616-391-3130
Is Sole Proprietor?:No
Enumeration Date:2018-06-28
Last Update Date:2018-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI43011156642085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology