Healthcare Provider Details

I. General information

NPI: 1154346658
Provider Name (Legal Business Name): HUYEN NGOC T BARTHOLOMEW M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: HUYEN NGOC TRANBERG BARTHOLOMEW MD

II. Dates (important events)

Enumeration Date: 07/13/2006
Last Update Date: 12/14/2023
Certification Date: 12/14/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1605 STATE ROUTE 60 VINEYARD SQUARE PLAZA #9
VERMILION OH
44089
US

IV. Provider business mailing address

1031 PIERCE ST SUITE
SANDUSKY OH
44870-4669
US

V. Phone/Fax

Practice location:
  • Phone: 440-967-1128
  • Fax: 440-967-1172
Mailing address:
  • Phone: 419-557-5568
  • Fax: 419-557-5542

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number35097630
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number35.097630
License Number StateOH
# 3
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number39446
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: