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General NPI Number Information
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NPI Number | 1366983686
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Entity Type | Individual
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Provider Name | NGUYEN Q HA M.D
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Gender | Male
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Dates
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Enumeration Date | 03/20/2017
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Last Update Date | 05/02/2024
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Provider Practice Location Address
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Address Line | 252 MCHENRY ST
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City | BURLINGTON
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State | WI
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Zip | 53105-1828
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Country | US
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Telephone | 262-767-6000
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 735044
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City | CHICAGO
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State | IL
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Zip | 60673-2843
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 73548
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License Number State | WI
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Taxonomy #3
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Taxonomy Code | 208M00000X
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Taxonomy Name | Hospitalist Physician
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License Number | 73548
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License Number State | WI
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