Provider Demographics
NPI:1679949580
Name:DOAN, TRUNG (PHARMD)
Entity Type:Individual
Prefix:
First Name:TRUNG
Middle Name:
Last Name:DOAN
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:35 STEINMETZ DR
Mailing Address - Street 2:
Mailing Address - City:MANCHESTER
Mailing Address - State:NH
Mailing Address - Zip Code:03104-1830
Mailing Address - Country:US
Mailing Address - Phone:603-512-6844
Mailing Address - Fax:
Practice Address - Street 1:1150 EASTMAN RD
Practice Address - Street 2:
Practice Address - City:CENTER CONWAY
Practice Address - State:NH
Practice Address - Zip Code:03813-4221
Practice Address - Country:US
Practice Address - Phone:603-356-5471
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-08-14
Last Update Date:2015-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH4034183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist