Provider Demographics
NPI:1942211636
Name:VU, HOAT (MD)
Entity Type:Individual
Prefix:DR
First Name:HOAT
Middle Name:
Last Name:VU
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 1:3390 N STATE RD
Mailing Address - Street 2:SUITE A
Mailing Address - City:DAVISON
Mailing Address - State:MI
Mailing Address - Zip Code:48423-1154
Mailing Address - Country:US
Mailing Address - Phone:810-653-9282
Mailing Address - Fax:810-658-0001
Practice Address - Street 1:3390 N STATE RD
Practice Address - Street 2:SUITE A
Practice Address - City:DAVISON
Practice Address - State:MI
Practice Address - Zip Code:48423-1154
Practice Address - Country:US
Practice Address - Phone:810-653-9282
Practice Address - Fax:810-658-0001
Is Sole Proprietor?:No
Enumeration Date:2006-08-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIHV040261208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4532180Medicaid
MI0N76190Medicare ID - Type Unspecified
MI4532180Medicaid