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General NPI Number Information
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NPI Number | 1851895098
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Entity Type | Individual
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Provider Name | DAN PHUONG NGUYEN MD
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Gender | Male
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Dates
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Enumeration Date | 03/21/2018
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Last Update Date | 07/16/2024
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Provider Practice Location Address
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Address Line | SPRING MILLS MEDICAL OFFICE 61 CAMPUS DR STE 300
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City | MARTINSBURG
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State | WV
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Zip | 25404-7542
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Country | US
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Telephone | 304-596-5160
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Fax | 304-596-5161
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Provider Business Mailing Address
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Address Line | SPRING MILLS MEDICAL OFFICE 61 CAMPUS DR STE 300
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City | MARTINSBURG
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State | WV
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Zip | 25404
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Country | US
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Telephone | 45-965-1603
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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 |
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Taxonomy #2
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number | 0101275001
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License Number State | VA
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