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General NPI Number Information
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NPI Number | 1902769383
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Entity Type | Individual
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Provider Name | MIA PHI NGUYEN
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Gender | Female
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Dates
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Enumeration Date | 12/03/2025
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Last Update Date | 12/03/2025
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Provider Practice Location Address
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Address Line | 1970 CHANDALAR OFFICE PARK
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City | PELHAM
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State | AL
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Zip | 35124-1312
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Country | US
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Telephone | 205-644-8640
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Fax | 205-574-3117
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Provider Business Mailing Address
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Address Line | 1970 CHANDALAR OFFICE PARK
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City | PELHAM
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State | AL
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Zip | 35124-1312
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Country | US
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Telephone | 205-644-8640
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Fax | 205-574-3117
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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 | 207QA0505X
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Taxonomy Name | Adult Medicine Physician
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License Number | 1-102463
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License Number State | AL
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