Provider Demographics
NPI:1467657031
Name:DO, MINH TUAN (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:MINH
Middle Name:TUAN
Last Name:DO
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24 PETERBOROUGH ST APT 16
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02215-4900
Mailing Address - Country:US
Mailing Address - Phone:617-308-9686
Mailing Address - Fax:617-542-4829
Practice Address - Street 1:400 TREMONT ST
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02116-6309
Practice Address - Country:US
Practice Address - Phone:617-542-2107
Practice Address - Fax:617-542-4829
Is Sole Proprietor?:No
Enumeration Date:2007-06-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA26373183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist