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General NPI Number Information
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NPI Number | 1346639242
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Entity Type | Organization
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Legal Business Name | DZUNG NGUYEN, M.D.
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Dates
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Enumeration Date | 01/15/2015
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Last Update Date | 01/15/2015
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Provider Practice Location Address
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Address Line | 2007 HARRISON AVE
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City | PANAMA CITY
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State | FL
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Zip | 32405-4545
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Country | US
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Telephone | 850-769-5224
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Fax | 850-769-4515
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Provider Business Mailing Address
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Address Line | 2007 HARRISON AVE
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City | PANAMA CITY
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State | FL
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Zip | 32405-4545
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Country | US
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Telephone | 850-769-5224
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Fax | 850-769-4515
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Authorized Official
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Title or Position | MANAGER
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Name | DR. DZUNG NGUYEN
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Credential | M.D.
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Telephone | 850-769-5224
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | ME0067893
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License Number State | FL
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