Provider Demographics
NPI:1801147392
Name:NGUYEN, KIM YEN T (MD)
Entity type:Individual
Prefix:
First Name:KIM YEN
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 1:7794 5 MILE RD STE 150
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45230-2373
Mailing Address - Country:US
Mailing Address - Phone:513-246-7016
Mailing Address - Fax:513-852-8957
Practice Address - Street 1:7794 5 MILE RD STE 150
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45230-2373
Practice Address - Country:US
Practice Address - Phone:513-246-7016
Practice Address - Fax:513-852-8957
Is Sole Proprietor?:No
Enumeration Date:2012-09-25
Last Update Date:2024-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35-122721207R00000X
OH35.122721207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine