Provider Demographics
NPI:1669567343
Name:HUYNH, MINH N (DO)
Entity type:Individual
Prefix:
First Name:MINH
Middle Name:N
Last Name:HUYNH
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 PLAZA DR STE 103
Mailing Address - Street 2:BUNKER HILL PLAZA
Mailing Address - City:SEWELL
Mailing Address - State:NJ
Mailing Address - Zip Code:08080-9207
Mailing Address - Country:US
Mailing Address - Phone:856-270-4080
Mailing Address - Fax:856-270-4085
Practice Address - Street 1:1 PLAZA DR STE 103
Practice Address - Street 2:BUNKER HILL PLAZA
Practice Address - City:SEWELL
Practice Address - State:NJ
Practice Address - Zip Code:08080-9207
Practice Address - Country:US
Practice Address - Phone:856-270-4080
Practice Address - Fax:856-270-4085
Is Sole Proprietor?:No
Enumeration Date:2006-10-04
Last Update Date:2010-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMB72667207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ2423514000OtherAMERIHEALTH, KEYSTONE, IBC
60014895OtherHORIZON NJ HEALTH
3744954OtherAETNA
NJ0056570Medicaid
NJ088401 B67Medicare PIN
NJ0056570Medicaid