Provider Demographics
NPI:1578663290
Name:THUANHANH T. NGUYEN, M.D., P.A.
Entity Type:Organization
Organization Name:THUANHANH T. NGUYEN, M.D., P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:THUANHANH
Authorized Official - Middle Name:THI
Authorized Official - Last Name:NGUYEN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:704-554-8880
Mailing Address - Street 1:PO BOX 240296
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28224-0296
Mailing Address - Country:US
Mailing Address - Phone:704-554-8880
Mailing Address - Fax:704-554-8883
Practice Address - Street 1:1433 EMERYWOOD DR
Practice Address - Street 2:STE D
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28210-4105
Practice Address - Country:US
Practice Address - Phone:704-554-8880
Practice Address - Fax:704-554-8883
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-23
Last Update Date:2011-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC200201583207R00000X
NC9901337208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
No208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty