Healthcare Provider Details

I. General information

NPI: 1477689727
Provider Name (Legal Business Name): TUYET THI NGUYEN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/23/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

COMMONWEALTH HEALTH CENTER SAIPAN MP 96950 1 LOWER MARY HILL ROAD
SAIPAN MP
96950
US

IV. Provider business mailing address

PMB 1402 POB 10002
SAIPAN MP
96950
US

V. Phone/Fax

Practice location:
  • Phone: 670-234-8950
  • Fax:
Mailing address:
  • Phone: 670-234-8950
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number0161
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: