Provider Demographics
NPI:1285660894
Name:NGUYEN, THEHUNG E (MD)
Entity Type:Individual
Prefix:DR
First Name:THEHUNG
Middle Name:E
Last Name:NGUYEN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6828 CREEKWOOD CT
Mailing Address - Street 2:
Mailing Address - City:CLARKSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21029-1746
Mailing Address - Country:US
Mailing Address - Phone:443-812-2662
Mailing Address - Fax:
Practice Address - Street 1:600 N CAROLINE ST # B150
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21205-1839
Practice Address - Country:US
Practice Address - Phone:410-955-1677
Practice Address - Fax:410-614-3198
Is Sole Proprietor?:No
Enumeration Date:2006-06-24
Last Update Date:2020-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0056893207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD298LE467Medicare PIN