Provider Demographics
NPI:1851607246
Name:NEWBERG FAMILY PRACTICE, LTD
Entity Type:Organization
Organization Name:NEWBERG FAMILY PRACTICE, LTD
Other - Org Name:AN C. VU, M.D.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:AN
Authorized Official - Middle Name:CONG
Authorized Official - Last Name:VU
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:503-538-7331
Mailing Address - Street 1:450 VILLA RD
Mailing Address - Street 2:
Mailing Address - City:NEWBERG
Mailing Address - State:OR
Mailing Address - Zip Code:97132-1857
Mailing Address - Country:US
Mailing Address - Phone:503-538-7331
Mailing Address - Fax:503-538-7333
Practice Address - Street 1:450 VILLA RD
Practice Address - Street 2:
Practice Address - City:NEWBERG
Practice Address - State:OR
Practice Address - Zip Code:97132-1857
Practice Address - Country:US
Practice Address - Phone:503-538-7331
Practice Address - Fax:503-538-7333
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-24
Last Update Date:2010-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORMD14665208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty