Provider Demographics
NPI:1972723799
Name:HUNG DO,M.D.,P.C.
Entity Type:Organization
Organization Name:HUNG DO,M.D.,P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:HUNG
Authorized Official - Middle Name:TRONG
Authorized Official - Last Name:DO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:978-458-6611
Mailing Address - Street 1:16 BRANCH ST
Mailing Address - Street 2:
Mailing Address - City:LOWELL
Mailing Address - State:MA
Mailing Address - Zip Code:01851-1803
Mailing Address - Country:US
Mailing Address - Phone:978-458-6611
Mailing Address - Fax:978-453-0545
Practice Address - Street 1:16 BRANCH ST
Practice Address - Street 2:
Practice Address - City:LOWELL
Practice Address - State:MA
Practice Address - Zip Code:01851-1803
Practice Address - Country:US
Practice Address - Phone:978-458-6611
Practice Address - Fax:978-453-0545
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-26
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA52138207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA9783741Medicaid
MAM19168Medicare ID - Type Unspecified