Provider Demographics
NPI:1669456513
Name:HUYNH, TUAN ANH (MD)
Entity Type:Individual
Prefix:
First Name:TUAN
Middle Name:ANH
Last Name:HUYNH
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 1:7940 WILLIAMS POND LANE
Mailing Address - Street 2:SUITE 250
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28277-8412
Mailing Address - Country:US
Mailing Address - Phone:704-542-2500
Mailing Address - Fax:704-542-2592
Practice Address - Street 1:7940 WILLIAMS POND LANE
Practice Address - Street 2:SUITE 250
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28277-8412
Practice Address - Country:US
Practice Address - Phone:704-542-2500
Practice Address - Fax:704-542-2592
Is Sole Proprietor?:No
Enumeration Date:2005-12-05
Last Update Date:2008-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC200300814207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC89135RVMedicaid
NC89135RVMedicaid
NC2021360Medicare ID - Type Unspecified