Provider Demographics
NPI:1700176179
Name:QUATTLEBAUM, THOMAS HENRY NGUYEN (MD)
Entity Type:Individual
Prefix:
First Name:THOMAS
Middle Name:HENRY NGUYEN
Last Name:QUATTLEBAUM
Suffix:
Gender:M
Credentials:MD
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Other - First Name:
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Mailing Address - Street 1:677 ALA MOANA BLVD STE 1001
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96813-5408
Mailing Address - Country:US
Mailing Address - Phone:808-469-4900
Mailing Address - Fax:808-536-7315
Practice Address - Street 1:95-390 KUAHELANI AVE
Practice Address - Street 2:
Practice Address - City:MILILANI
Practice Address - State:HI
Practice Address - Zip Code:96789-1192
Practice Address - Country:US
Practice Address - Phone:808-627-3200
Practice Address - Fax:808-623-7872
Is Sole Proprietor?:No
Enumeration Date:2011-04-19
Last Update Date:2020-02-13
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NMMD2015-0527207Q00000X
HIMD-20848207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine