Provider Demographics
NPI:1952513830
Name:TRAN, MICHAEL NGOC (MD)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:NGOC
Last Name:TRAN
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 1:200 MCGEE ROAD
Mailing Address - Street 2:
Mailing Address - City:ANDERSON
Mailing Address - State:SC
Mailing Address - Zip Code:29625
Mailing Address - Country:US
Mailing Address - Phone:864-260-2220
Mailing Address - Fax:864-716-2339
Practice Address - Street 1:200 MCGEE ROAD
Practice Address - Street 2:
Practice Address - City:ANDERSON
Practice Address - State:SC
Practice Address - Zip Code:29625
Practice Address - Country:US
Practice Address - Phone:864-260-2220
Practice Address - Fax:864-716-2339
Is Sole Proprietor?:No
Enumeration Date:2007-05-04
Last Update Date:2019-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC32683103T00000X, 2084P0800X
OH35.092861103T00000X
OH570126212084P0800X
SCMMD.32683TL2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No103T00000XBehavioral Health & Social Service ProvidersPsychologist