Provider Demographics
NPI:1295759595
Name:NGUYEN, DINH V (MD)
Entity type:Individual
Prefix:
First Name:DINH
Middle Name:V
Last Name:NGUYEN
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 1:633 S FEDERAL BLVD
Mailing Address - Street 2:STE 201
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80219-2933
Mailing Address - Country:US
Mailing Address - Phone:303-935-3566
Mailing Address - Fax:303-935-5029
Practice Address - Street 1:633 S FEDERAL BLVD
Practice Address - Street 2:STE 201
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80219-2933
Practice Address - Country:US
Practice Address - Phone:303-935-3566
Practice Address - Fax:303-935-5029
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-27
Last Update Date:2008-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO31392207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO01313923Medicaid
C67581Medicare PIN
CO01313923Medicaid