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General NPI Number Information
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NPI Number | 1578663290
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Entity Type | Organization
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Legal Business Name | THUANHANH T. NGUYEN, M.D., P.A.
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Dates
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Enumeration Date | 09/23/2006
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Last Update Date | 11/15/2011
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Provider Practice Location Address
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Address Line | 1433 EMERYWOOD DR STE D
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City | CHARLOTTE
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State | NC
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Zip | 28210-4105
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Country | US
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Telephone | 704-554-8880
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Fax | 704-554-8883
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Provider Business Mailing Address
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Address Line | PO BOX 240296
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City | CHARLOTTE
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State | NC
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Zip | 28224-0296
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Country | US
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Telephone | 704-554-8880
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Fax | 704-554-8883
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Authorized Official
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Title or Position | PRESIDENT/OWNER
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Name | DR. THUANHANH THI NGUYEN
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Credential | M.D.
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Telephone | 704-554-8880
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 9901337
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License Number State | NC
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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 | 200201583
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License Number State | NC
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