Provider Demographics
NPI:1194857185
Name:NGUYEN, QUANG VINH (DO)
Entity Type:Individual
Prefix:
First Name:QUANG
Middle Name:VINH
Last Name:NGUYEN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3421 CONCORD RD
Mailing Address - Street 2:
Mailing Address - City:YORK
Mailing Address - State:PA
Mailing Address - Zip Code:17402-9001
Mailing Address - Country:US
Mailing Address - Phone:717-851-4005
Mailing Address - Fax:717-812-2495
Practice Address - Street 1:1001 S GEORGE ST
Practice Address - Street 2:3RD FLOOR
Practice Address - City:YORK
Practice Address - State:PA
Practice Address - Zip Code:17403-3676
Practice Address - Country:US
Practice Address - Phone:717-851-4005
Practice Address - Fax:717-812-2495
Is Sole Proprietor?:No
Enumeration Date:2007-03-12
Last Update Date:2022-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS013885207R00000X, 208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA111164OtherGEISINGER
PA30131833OtherAMERIHEALTH MERCY - WMG
MD897872OtherCAREFIRST MD BCBS
PA101938390Medicaid
PA211399OtherJOHNS HOPKINS
2161248OtherMAMSI-WMG
PA50070970OtherCAPITAL BLUE CROSS-WMG
PA217504OtherUNISON-WMG
PA9123073OtherAETNA
PA20090414OtherAMERIHEALTH MERCY
PA1973178OtherHIGHMARK BLUE SHIELD
MD034078200Medicaid
PA1563747OtherGATEWAY-WMG
PA30131833OtherAMERIHEALTH MERCY - WMG
PA113226EZ3Medicare PIN