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NPI Code Detail

MEDICARE: DR. MYLOAN THI NGUYEN O.D.

MEDICARE: DR. MYLOAN THI NGUYEN O.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1152W00000XOptometristI3-0001361DE

General Provider Information

NPI Number : 1588911739
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MYLOAN THI NGUYEN O.D.
Provider Business Mailing Address
First Line : 17059 S BRANDT ST
Second Line : 3108
City : LEWES
State : DE
Zip : 19958-7202
Country : US
Telephone Number : 240-938-0519
Fax Number :
Provider Business Practice Location Address
First Line : 502 W MARKET ST
Second Line :
City : GEORGETOWN
State : DE
Zip : 19947-2322
Country : US
Telephone Number : 302-856-2020
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/07/2012
Last Update Date : 03/07/2013

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