Provider Demographics
NPI:1497804595
Name:DOAN, BAO THUY THI (MD)
Entity Type:Individual
Prefix:MRS
First Name:BAO THUY
Middle Name:THI
Last Name:DOAN
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 1:9465 E CHARTER OAK DR
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85260-5057
Mailing Address - Country:US
Mailing Address - Phone:480-421-8314
Mailing Address - Fax:
Practice Address - Street 1:5601 W EUGIE AVE
Practice Address - Street 2:SUITE 100
Practice Address - City:GLENDALE
Practice Address - State:AZ
Practice Address - Zip Code:85304-1255
Practice Address - Country:US
Practice Address - Phone:602-978-1500
Practice Address - Fax:602-978-0409
Is Sole Proprietor?:No
Enumeration Date:2007-01-09
Last Update Date:2012-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZAZ32859207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ867145Medicaid
AZ867145Medicaid
I09546Medicare UPIN