Provider Demographics
NPI:1962455741
Name:NGUYEN, HIEU T (MD)
Entity Type:Individual
Prefix:
First Name:HIEU
Middle Name:T
Last Name:NGUYEN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2665 N DECATUR RD
Mailing Address - Street 2:SUITE 330
Mailing Address - City:DECATUR
Mailing Address - State:GA
Mailing Address - Zip Code:30033-6149
Mailing Address - Country:US
Mailing Address - Phone:404-297-9755
Mailing Address - Fax:404-297-5008
Practice Address - Street 1:2665 N DECATUR RD
Practice Address - Street 2:SUITE 330
Practice Address - City:DECATUR
Practice Address - State:GA
Practice Address - Zip Code:30033-6149
Practice Address - Country:US
Practice Address - Phone:404-297-9755
Practice Address - Fax:404-297-5008
Is Sole Proprietor?:No
Enumeration Date:2006-05-19
Last Update Date:2022-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC87737207RI0200X
GA033163207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA00439601AMedicaid
GA11BDCQVMedicare ID - Type Unspecified