Provider Demographics
NPI:1952382517
Name:NGUYEN, TRINH (DO)
Entity Type:Individual
Prefix:DR
First Name:TRINH
Middle Name:
Last Name:NGUYEN
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 1:401 S BALLENGER HWY
Mailing Address - Street 2:
Mailing Address - City:FLINT
Mailing Address - State:MI
Mailing Address - Zip Code:48532-3638
Mailing Address - Country:US
Mailing Address - Phone:810-342-1000
Mailing Address - Fax:810-342-1590
Practice Address - Street 1:2316 S CEDAR ST
Practice Address - Street 2:
Practice Address - City:LANSING
Practice Address - State:MI
Practice Address - Zip Code:48910-3152
Practice Address - Country:US
Practice Address - Phone:517-702-4130
Practice Address - Fax:517-702-4139
Is Sole Proprietor?:No
Enumeration Date:2005-11-10
Last Update Date:2016-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5101011389207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0100309OtherPHYSICIANS HEALTH PLAN
MI080D410020OtherCOMMUNITY BLUE PPO
MI4627071OtherAETNA
MI4723825Medicaid
MI080D410020OtherBLUE CROSS BLUE SHIELD
MI0853301474OtherBLUE CROSS BLUE SHIELD
MI080D410020OtherBLUE CHOICE
MI201481OtherHEALTH ADVANTAGE NETWORK
MI4511340Medicaid
MI201481OtherMCLAREN HEALTH PLAN
MI4162894Medicaid
MIF67647OtherHEALTH NET FED SERVICES
MI080D410020OtherBLUE CARE NETWORK
MI4511340Medicaid