Provider Demographics
NPI:1437175817
Name:TRAN, THANH Q (MD)
Entity Type:Individual
Prefix:DR
First Name:THANH
Middle Name:Q
Last Name:TRAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:THANH
Other - Middle Name:Q
Other - Last Name:ANDREAKOS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:309 W JOHNSON ST APT 716
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53703-3553
Mailing Address - Country:US
Mailing Address - Phone:608-302-9311
Mailing Address - Fax:
Practice Address - Street 1:111 E WISCONSIN AVE STE 2100
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53202-4809
Practice Address - Country:US
Practice Address - Phone:414-290-6700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-15
Last Update Date:2020-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI39995207PT0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207PT0002XAllopathic & Osteopathic PhysiciansEmergency MedicineMedical Toxicology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI32475000Medicaid
WI32475000Medicaid