Provider Demographics
NPI:1801997317
Name:NGUYEN, TUONG (MD)
Entity type:Individual
Prefix:
First Name:TUONG
Middle Name:
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 1:6404 ALBEMARLE RD
Mailing Address - Street 2:SUITE J&K
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28212-3800
Mailing Address - Country:US
Mailing Address - Phone:704-532-8884
Mailing Address - Fax:704-532-8789
Practice Address - Street 1:6404 ALBEMARLE RD
Practice Address - Street 2:SUITE J&K
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28212-3800
Practice Address - Country:US
Practice Address - Phone:704-532-8884
Practice Address - Fax:704-532-8789
Is Sole Proprietor?:No
Enumeration Date:2006-09-26
Last Update Date:2014-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2000-00566207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
H07190Medicare UPIN
NC2281231AMedicare ID - Type Unspecified