Healthcare Provider Details

I. General information

NPI: 1144278854
Provider Name (Legal Business Name): VI NGHIEP HUA MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/04/2006
Last Update Date: 03/07/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13555 W MCDOWELL RD SUITE 304
GOODYEAR AZ
85395-2624
US

IV. Provider business mailing address

13555 W MCDOWELL RD SUITE 304
GOODYEAR AZ
85395-2624
US

V. Phone/Fax

Practice location:
  • Phone: 623-935-5522
  • Fax: 623-935-3220
Mailing address:
  • Phone: 623-935-5522
  • Fax: 623-935-3220

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208800000X
TaxonomyUrology Physician
License Number35436
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: