Provider Demographics
NPI:1235310004
Name:SOM, HANH-DUNG TRAN (MD)
Entity Type:Individual
Prefix:DR
First Name:HANH-DUNG
Middle Name:TRAN
Last Name:SOM
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:HANH-DUNG
Other - Middle Name:
Other - Last Name:TRAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:3101 EMRICK BLVD
Mailing Address - Street 2:SUITE 112
Mailing Address - City:BETHLEHEM
Mailing Address - State:PA
Mailing Address - Zip Code:18020-8037
Mailing Address - Country:US
Mailing Address - Phone:610-419-6426
Mailing Address - Fax:610-438-6135
Practice Address - Street 1:3101 EMRICK BLVD
Practice Address - Street 2:SUITE 112
Practice Address - City:BETHLEHEM
Practice Address - State:PA
Practice Address - Zip Code:18020-8037
Practice Address - Country:US
Practice Address - Phone:610-419-6426
Practice Address - Fax:610-438-6135
Is Sole Proprietor?:No
Enumeration Date:2007-11-20
Last Update Date:2016-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD455951207Q00000X
MN52884207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN080019656Medicare PIN