Healthcare Provider Details

I. General information

NPI: 1881769693
Provider Name (Legal Business Name): VUONG MD INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/21/2006
Last Update Date: 10/22/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

182 NORTH BREIEL BOULEVARD
MIDDLETOWN OH
45042
US

IV. Provider business mailing address

182 N BREIEL BLVD
MIDDLETOWN OH
45042-3802
US

V. Phone/Fax

Practice location:
  • Phone: 513-423-1429
  • Fax: 513-423-1299
Mailing address:
  • Phone: 513-423-1429
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License Number35056968
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number35056968
License Number StateOH
# 3
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number35056968
License Number StateOH

VIII. Authorized Official

Name: PHUONG HOANG VUONG
Title or Position: PRESIDENT VUONG MD INC
Credential: MD
Phone: 513-423-1429