Provider Demographics
NPI:1629000344
Name:NGUYEN, ELIZABETH THUY (MD)
Entity Type:Individual
Prefix:DR
First Name:ELIZABETH
Middle Name:THUY
Last Name:NGUYEN
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 1:980 JOHNSON FERRY ROAD NE
Mailing Address - Street 2:SUITE 410
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30342
Mailing Address - Country:US
Mailing Address - Phone:404-252-0256
Mailing Address - Fax:404-252-9658
Practice Address - Street 1:980 JOHNSON FERRY ROAD NE
Practice Address - Street 2:SUITE 410
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30342
Practice Address - Country:US
Practice Address - Phone:404-252-0256
Practice Address - Fax:404-252-9658
Is Sole Proprietor?:No
Enumeration Date:2006-07-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA055682207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA146791OtherBCBS GEORGIA
GA146791OtherBCBS GEORGIA
GA39BDCLCMedicare ID - Type Unspecified
GAI30630Medicare UPIN