Provider Demographics
NPI:1578787024
Name:BUI, BAO-ANH NGOC (MD)
Entity Type:Individual
Prefix:
First Name:BAO-ANH
Middle Name:NGOC
Last Name:BUI
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:PO BOX 2582
Mailing Address - Street 2:
Mailing Address - City:BRYSON CITY
Mailing Address - State:NC
Mailing Address - Zip Code:28713-2582
Mailing Address - Country:US
Mailing Address - Phone:910-239-8100
Mailing Address - Fax:828-538-4441
Practice Address - Street 1:1756 METROMEDICAL DR
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28304-3861
Practice Address - Country:US
Practice Address - Phone:910-485-8831
Practice Address - Fax:866-559-1259
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-13
Last Update Date:2023-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2009-01251207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC2075474BOtherMEDICARE PTAN
NCP01034103OtherRAILROAD MEDICARE