MEDICARE: LONG HOANG NGUYEN M.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
1	207Q00000X	Family Medicine Physician	4301118887	MI

General Provider Information

NPI Number	:	1700237468
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LONG HOANG NGUYEN M.D.

Provider Business Mailing Address
First Line	:	1410 S HURDS CORNER RD
Second Line	:
City	:	CARO
State	:	MI
Zip	:	48723-9471
Country	:	US
Telephone Number	:	760-519-3570
Fax Number	:

Provider Business Practice Location Address
First Line	:	4675 HILL ST
Second Line	:
City	:	CASS CITY
State	:	MI
Zip	:	48726-1099
Country	:	US
Telephone Number	:	989-872-2121
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/23/2016
Last Update Date	:	05/08/2024

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