Provider Demographics
NPI:1861657702
Name:NGUYEN, VINH (MD)
Entity Type:Individual
Prefix:
First Name:VINH
Middle Name:
Last Name:NGUYEN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:48 MEDICAL PARK EAST DR
Mailing Address - Street 2:STE 150
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35235-3456
Mailing Address - Country:US
Mailing Address - Phone:205-833-6907
Mailing Address - Fax:205-833-6987
Practice Address - Street 1:48 MEDICAL PARK EAST DR
Practice Address - Street 2:STE 150
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35235-3456
Practice Address - Country:US
Practice Address - Phone:205-833-6907
Practice Address - Fax:205-833-6987
Is Sole Proprietor?:No
Enumeration Date:2008-07-21
Last Update Date:2010-10-29
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
ARE-5731208600000X
AL30321208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL121803Medicaid
AR176488001Medicaid
AR176488001Medicaid