Healthcare Provider Details

I. General information

NPI: 1669567343
Provider Name (Legal Business Name): MINH N HUYNH DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/04/2006
Last Update Date: 10/21/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 PLAZA DR STE 103 BUNKER HILL PLAZA
SEWELL NJ
08080-9207
US

IV. Provider business mailing address

1 PLAZA DR STE 103 BUNKER HILL PLAZA
SEWELL NJ
08080-9207
US

V. Phone/Fax

Practice location:
  • Phone: 856-270-4080
  • Fax: 856-270-4085
Mailing address:
  • Phone: 856-270-4080
  • Fax: 856-270-4085

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberMB72667
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: