Healthcare Provider Details

I. General information

NPI: 1033300025
Provider Name (Legal Business Name): BINH THAI NGUYEN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/06/2007
Last Update Date: 08/09/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 ALBERT SABIN WAY
CINCINNATI OH
45267
US

IV. Provider business mailing address

4685 FOREST AVE
CINCINNATI OH
45212-3359
US

V. Phone/Fax

Practice location:
  • Phone: 513-558-4363
  • Fax:
Mailing address:
  • Phone: 132-467-0005
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208200000X
TaxonomyPlastic Surgery Physician
License Number35130448
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberBP1-0029123
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: