Provider Demographics
NPI:1821050089
Name:DAO, MINH CONG (MD)
Entity Type:Individual
Prefix:DR
First Name:MINH
Middle Name:CONG
Last Name:DAO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:4657 ALCEE FORTIER BLVD
Mailing Address - Street 2:SUITE-A
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70129-2140
Mailing Address - Country:US
Mailing Address - Phone:504-254-4011
Mailing Address - Fax:504-254-4016
Practice Address - Street 1:4657 ALCEE FORTIER BLVD
Practice Address - Street 2:SUITE-A
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70129-2140
Practice Address - Country:US
Practice Address - Phone:504-254-4011
Practice Address - Fax:504-254-4016
Is Sole Proprietor?:No
Enumeration Date:2006-04-04
Last Update Date:2008-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA09214R207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1675261Medicaid
LA110195035Medicare PIN
LA1675261Medicaid
LA5W629Medicare PIN
LAG22228Medicare UPIN