Provider Demographics
NPI:1326144841
Name:NGUYEN, KHANH HONG (MD)
Entity Type:Individual
Prefix:MR
First Name:KHANH
Middle Name:HONG
Last Name:NGUYEN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:880 CENTURY DR FL 1
Mailing Address - Street 2:
Mailing Address - City:MECHANICSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17055-4375
Mailing Address - Country:US
Mailing Address - Phone:717-691-3235
Mailing Address - Fax:717-691-3243
Practice Address - Street 1:640 S STATE ST FL 1
Practice Address - Street 2:
Practice Address - City:DOVER
Practice Address - State:DE
Practice Address - Zip Code:19901-3530
Practice Address - Country:US
Practice Address - Phone:302-674-4401
Practice Address - Fax:302-674-4129
Is Sole Proprietor?:No
Enumeration Date:2006-09-15
Last Update Date:2023-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA961682085R0001X
NJ25MA081736002085R0001X
DEC1-00100532085R0001X
PAMD4214002085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
1326144841OtherNPI
DEC1-0010053OtherMEDICAL LICENSE
I30753Medicare UPIN