Healthcare Provider Details
I. General information
NPI: 1184928392
Provider Name (Legal Business Name): ZUNG MY HOANG M.D
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 01/03/2011
Last Update Date: 05/29/2018
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
9 TROLLEY CROSSING RD
CHARLTON MA
01507
US
IV. Provider business mailing address
9 TROLLEY CROSSING RD
CHARLTON MA
01507-1351
US
V. Phone/Fax
- Phone: 508-980-7055
- Fax:
- Phone: 508-980-7055
- Fax: 508-980-7072
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207V00000X |
| Taxonomy | Obstetrics & Gynecology Physician |
| License Number | 54462 |
| License Number State | CT |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207V00000X |
| Taxonomy | Obstetrics & Gynecology Physician |
| License Number | 256102 |
| License Number State | MA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: