Healthcare Provider Details

I. General information

NPI: 1659073336
Provider Name (Legal Business Name): MINH ANH NGUYEN DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/20/2023
Last Update Date: 06/25/2026
Certification Date: 06/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4818 BLUFFTON PKWY
BLUFFTON SC
29910-4602
US

IV. Provider business mailing address

4818 BLUFFTON PKWY
BLUFFTON SC
29910-4602
US

V. Phone/Fax

Practice location:
  • Phone: 843-706-0600
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number96730
License Number StateSC
# 2
Primary TaxonomyN
Taxonomy Code207RH0002X
TaxonomyHospice and Palliative Medicine (Internal Medicine) Physician
License Number110198
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: