Provider Demographics
NPI:1881776557
Name:HOANG, TUAN ANH (MD)
Entity type:Individual
Prefix:
First Name:TUAN
Middle Name:ANH
Last Name:HOANG
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 1:909 S 8TH ST
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19147-3942
Mailing Address - Country:US
Mailing Address - Phone:215-925-1430
Mailing Address - Fax:215-925-1134
Practice Address - Street 1:909 S 8TH ST
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19147-3942
Practice Address - Country:US
Practice Address - Phone:215-925-1430
Practice Address - Fax:215-925-1134
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-20
Last Update Date:2010-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD030694E207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAHO33501Medicare ID - Type Unspecified
PAB33944Medicare UPIN