Provider Demographics
NPI:1427032952
Name:TRINH, CHANNHU (MD)
Entity Type:Individual
Prefix:DR
First Name:CHANNHU
Middle Name:
Last Name:TRINH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2933 MAGINN DR
Mailing Address - Street 2:
Mailing Address - City:BEAVERCREEK
Mailing Address - State:OH
Mailing Address - Zip Code:45434-5831
Mailing Address - Country:US
Mailing Address - Phone:740-644-3037
Mailing Address - Fax:
Practice Address - Street 1:3371 KEMP RD
Practice Address - Street 2:
Practice Address - City:BEAVERCREEK
Practice Address - State:OH
Practice Address - Zip Code:45431-2514
Practice Address - Country:US
Practice Address - Phone:937-458-4200
Practice Address - Fax:937-458-4209
Is Sole Proprietor?:No
Enumeration Date:2005-11-29
Last Update Date:2013-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01048969A207Q00000X
OH35087874207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
P01034947OtherRAILROAD MEDICARE PIN
IN200335580Medicaid
OH2663667Medicaid
H03916Medicare UPIN
7412291Medicare PIN
OH4249022Medicare PIN
IN200335580Medicaid