Healthcare Provider Details

I. General information

NPI: 1558470591
Provider Name (Legal Business Name): ADVANCED SURGICAL SPECIALISTS, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/30/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

510 CHERRY ST SUITE # 105
BLUEFIELD WV
24701-3338
US

IV. Provider business mailing address

510 CHERRY ST SUITE # 105
BLUEFIELD WV
24701-3338
US

V. Phone/Fax

Practice location:
  • Phone: 304-325-1905
  • Fax:
Mailing address:
  • Phone: 304-325-1905
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code208G00000X
TaxonomyThoracic Surgery (Cardiothoracic Vascular Surgery) Physician
License Number
License Number State

VIII. Authorized Official

Name: CHIEU DINH NGUYEN
Title or Position: PHYSICIAN
Credential: M.D.
Phone: 304-325-1905