Provider Demographics
NPI:1497746648
Name:NGUYEN, ANH X (MD)
Entity Type:Individual
Prefix:
First Name:ANH
Middle Name:X
Last Name:NGUYEN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2024 S 6TH ST
Mailing Address - Street 2:
Mailing Address - City:BRAINERD
Mailing Address - State:MN
Mailing Address - Zip Code:56401-4529
Mailing Address - Country:US
Mailing Address - Phone:320-252-5131
Mailing Address - Fax:320-240-2118
Practice Address - Street 1:1200 6TH AVE N
Practice Address - Street 2:
Practice Address - City:SAINT CLOUD
Practice Address - State:MN
Practice Address - Zip Code:56303-2735
Practice Address - Country:US
Practice Address - Phone:320-252-5131
Practice Address - Fax:320-240-2118
Is Sole Proprietor?:No
Enumeration Date:2005-11-04
Last Update Date:2017-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN385552084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
HP31010OtherHEALTH PARTNERS
2116694OtherFIRST HEALTH PLAN
1025056OtherPREFERRED ONE
91D76NGOtherBLUE CROSS BLUE SHIELD
0500112OtherMEDICA HEALTH PLANS
1079982OtherARAZ GROUP/AMERICA'S PPO
140078OtherU-CARE
944602800OtherMEDICAL ASSISTANCE (MA)
H16864Medicare UPIN
140078OtherU-CARE