Provider Demographics
NPI:1407421944
Name:NGUYEN, VIET ANH LE (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:VIET ANH
Middle Name:LE
Last Name:NGUYEN
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:DR
Other - First Name:VICTOR
Other - Middle Name:LE
Other - Last Name:NGUYEN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PHARMD
Mailing Address - Street 1:24409 BONNIE BROOK DR
Mailing Address - Street 2:
Mailing Address - City:NOVI
Mailing Address - State:MI
Mailing Address - Zip Code:48374-3009
Mailing Address - Country:US
Mailing Address - Phone:248-912-8666
Mailing Address - Fax:
Practice Address - Street 1:31250 BECK RD
Practice Address - Street 2:
Practice Address - City:NOVI
Practice Address - State:MI
Practice Address - Zip Code:48377-1022
Practice Address - Country:US
Practice Address - Phone:248-624-4110
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-05-26
Last Update Date:2021-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5302413048183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist