Healthcare Provider Details

I. General information

NPI: 1952444622
Provider Name (Legal Business Name): PETER HOANG NGUYEN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: HOANG MINH NGUYEN MD

II. Dates (important events)

Enumeration Date: 02/14/2007
Last Update Date: 07/09/2026
Certification Date: 07/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9200 W WISCONSIN AVE
MILWAUKEE WI
53226-3522
US

IV. Provider business mailing address

9200 W WISCONSIN AVE
MILWAUKEE WI
53226-3522
US

V. Phone/Fax

Practice location:
  • Phone: 414-805-8710
  • Fax: 414-955-0115
Mailing address:
  • Phone: 414-805-8710
  • Fax: 414-955-0115

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207T00000X
TaxonomyNeurological Surgery Physician
License Number37013-020
License Number StateWI
# 2
Primary TaxonomyN
Taxonomy Code207T00000X
TaxonomyNeurological Surgery Physician
License NumberA75745
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: