Healthcare Provider Details

I. General information

NPI: 1982749511
Provider Name (Legal Business Name): DYLAN VINH NGUYEN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/21/2007
Last Update Date: 04/05/2022
Certification Date: 03/01/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

619 19TH ST S
BIRMINGHAM AL
35249-3600
US

IV. Provider business mailing address

619 19TH ST S
BIRMINGHAM AL
35249-1900
US

V. Phone/Fax

Practice location:
  • Phone: 205-934-4696
  • Fax:
Mailing address:
  • Phone: 205-934-4696
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberA116104
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number43849
License Number StateAL
# 3
Primary TaxonomyY
Taxonomy Code207LC0200X
TaxonomyCritical Care Medicine (Anesthesiology) Physician
License Number43849
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: