Healthcare Provider Details

I. General information

NPI: 1841879210
Provider Name (Legal Business Name): LINDA NGUYEN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/05/2021
Last Update Date: 10/02/2026
Certification Date: 10/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1595 CLEVELAND AVE
EAST POINT GA
30344-3200
US

IV. Provider business mailing address

1605 ROBERTA DR SW
MARIETTA GA
30008-3855
US

V. Phone/Fax

Practice location:
  • Phone: 404-616-2886
  • Fax:
Mailing address:
  • Phone: 770-419-3120
  • Fax: 770-419-3121

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number101176
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: