Provider Demographics
NPI:1689667537
Name:TRAN, TUONGVAN T (MD)
Entity Type:Individual
Prefix:DR
First Name:TUONGVAN
Middle Name:T
Last Name:TRAN
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:104 NW STATE ROUTE 7
Mailing Address - Street 2:STE B
Mailing Address - City:BLUE SPRINGS
Mailing Address - State:MO
Mailing Address - Zip Code:64014-2749
Mailing Address - Country:US
Mailing Address - Phone:816-229-8880
Mailing Address - Fax:816-229-4363
Practice Address - Street 1:104 NO. 7 HIGHWAY
Practice Address - Street 2:SUITE B
Practice Address - City:BLUE SPRINGS
Practice Address - State:MO
Practice Address - Zip Code:64014
Practice Address - Country:US
Practice Address - Phone:816-229-8880
Practice Address - Fax:816-229-4363
Is Sole Proprietor?:No
Enumeration Date:2005-08-25
Last Update Date:2020-05-05
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MOMD105765207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO0973270OtherAETNA
MO22486123OtherBC/BS
MO0973270OtherAETNA
MO2938022AMedicare ID - Type Unspecified