Healthcare Provider Details

I. General information

NPI: 1548254170
Provider Name (Legal Business Name): NGHIA HUU NGUYEN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/09/2005
Last Update Date: 01/24/2025
Certification Date: 01/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 TUSKEGEE BLVD
DOVER AFB DE
19902-5300
US

IV. Provider business mailing address

300 TUSKEGEE BLVD
DOVER AFB DE
19902-5003
US

V. Phone/Fax

Practice location:
  • Phone: 302-677-2525
  • Fax: 302-677-2526
Mailing address:
  • Phone: 302-677-3598
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberD0050645
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: