MEDICARE: MINH VAN NGUYEN MD

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	208D00000X	General Practice Physician	MD00020746	WA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1962494070
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MINH VAN NGUYEN MD

Provider Business Mailing Address
First Line	:	9431 17TH AVE SW
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98106-2710
Country	:	US
Telephone Number	:	206-763-9621
Fax Number	:	206-767-6028

Provider Business Practice Location Address
First Line	:	9431 17TH AVE SW
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98106-2710
Country	:	US
Telephone Number	:	206-763-9621
Fax Number	:	206-767-6028

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

Provider Enumeration Date	:	08/16/2005
Last Update Date	:	11/16/2007

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Directions to “ MINH VAN NGUYEN MD” Practice Location

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