Healthcare Provider Details

I. General information

NPI: 1780258277
Provider Name (Legal Business Name): ANH THU VU HOANG DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/18/2021
Last Update Date: 05/18/2021
Certification Date: 05/18/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1200 S CEDAR CREST BLVD
ALLENTOWN PA
18103-6202
US

IV. Provider business mailing address

707 HAMILTON ST FL 9
ALLENTOWN PA
18101-2407
US

V. Phone/Fax

Practice location:
  • Phone: 713-349-3966
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberOT020850
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: