Provider Demographics
NPI:1760459911
Name:DUTHINH, VUONG (MD)
Entity Type:Individual
Prefix:
First Name:VUONG
Middle Name:
Last Name:DUTHINH
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 1:3399 POLLOCK RD
Mailing Address - Street 2:
Mailing Address - City:GRAND BLANC
Mailing Address - State:MI
Mailing Address - Zip Code:48439-8393
Mailing Address - Country:US
Mailing Address - Phone:810-603-0170
Mailing Address - Fax:810-579-1705
Practice Address - Street 1:3399 POLLOCK RD
Practice Address - Street 2:
Practice Address - City:GRAND BLANC
Practice Address - State:MI
Practice Address - Zip Code:48439-8393
Practice Address - Country:US
Practice Address - Phone:810-603-0170
Practice Address - Fax:810-579-1705
Is Sole Proprietor?:No
Enumeration Date:2006-03-07
Last Update Date:2016-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301066994207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4623070Medicaid
MI0998908OtherHEALTH PLUS OF MICHIGAN
MIG03991Medicare UPIN
MI0M34870014Medicare PIN