Provider Demographics
NPI:1760602064
Name:TRAN, NGHIA VAN (MD)
Entity Type:Individual
Prefix:MR
First Name:NGHIA
Middle Name:VAN
Last Name:TRAN
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 1:284 RIDGEVIEW CIRCLE
Mailing Address - Street 2:
Mailing Address - City:BLAIRSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:15717-1161
Mailing Address - Country:US
Mailing Address - Phone:724-459-6686
Mailing Address - Fax:
Practice Address - Street 1:355 HARVEY AVE
Practice Address - Street 2:
Practice Address - City:GREENSBURG
Practice Address - State:PA
Practice Address - Zip Code:15601-1911
Practice Address - Country:US
Practice Address - Phone:724-836-5100
Practice Address - Fax:800-359-9954
Is Sole Proprietor?:No
Enumeration Date:2007-04-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD030438E208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice