Healthcare Provider Details

I. General information

NPI: 1750884110
Provider Name (Legal Business Name): THANG VU DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/13/2018
Last Update Date: 09/20/2022
Certification Date: 09/20/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1900 23RD ST
CUYAHOGA FALLS OH
44223-1404
US

IV. Provider business mailing address

3488 QUEEN VICTORIA CT
BEAVERCREEK OH
45431-5710
US

V. Phone/Fax

Practice location:
  • Phone: 330-971-7000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number02006329A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: