Provider Demographics
NPI:1275643793
Name:VU, DUCTHANH N (MD)
Entity Type:Individual
Prefix:DR
First Name:DUCTHANH
Middle Name:N
Last Name:VU
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:DUC-THANH
Other - Middle Name:N
Other - Last Name:VU
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 403631
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30384-3631
Mailing Address - Country:US
Mailing Address - Phone:770-740-0895
Mailing Address - Fax:770-740-0896
Practice Address - Street 1:2202 STATE AVE
Practice Address - Street 2:SUITE 303 B
Practice Address - City:PANAMA CITY
Practice Address - State:FL
Practice Address - Zip Code:32405-7601
Practice Address - Country:US
Practice Address - Phone:850-770-8120
Practice Address - Fax:850-770-8137
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL96633207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine