Provider Demographics
NPI:1174817134
Name:NAYIMA, VUONG ANH (DO)
Entity Type:Individual
Prefix:DR
First Name:VUONG
Middle Name:ANH
Last Name:NAYIMA
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:VUONG
Other - Middle Name:ANH THE
Other - Last Name:NGUYEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5901 WESTOWN PKWY STE 225
Mailing Address - Street 2:
Mailing Address - City:WEST DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50266-8297
Mailing Address - Country:US
Mailing Address - Phone:773-257-7026
Mailing Address - Fax:844-595-5188
Practice Address - Street 1:5901 WESTOWN PKWY STE 225
Practice Address - Street 2:
Practice Address - City:WEST DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50266-8297
Practice Address - Country:US
Practice Address - Phone:515-410-9400
Practice Address - Fax:844-595-5188
Is Sole Proprietor?:No
Enumeration Date:2011-06-07
Last Update Date:2019-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAR9217207R00000X
IADO-04341208M00000X
IA4341207K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & Immunology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0123134Medicaid
P02168477OtherMEDICARE RR
IAIB4258001OtherMEDICARE IA