MEDICARE: MINH T TRAN D.O.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208100000X	Physical Medicine & Rehabilitation Physician	217139	MA
2	208100000X	Physical Medicine & Rehabilitation Physician	12721	NH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1063526952
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MINH T TRAN D.O.

Provider Business Mailing Address
First Line	:	PO BOX 412503
Second Line	:
City	:	BOSTON
State	:	MA
Zip	:	02241-2503
Country	:	US
Telephone Number	:	603-431-5529
Fax Number	:	603-436-6603

Provider Business Practice Location Address
First Line	:	67 CORPORATE DR STE 200
Second Line	:
City	:	PORTSMOUTH
State	:	NH
Zip	:	03801-2847
Country	:	US
Telephone Number	:	603-431-5529
Fax Number	:	603-436-6603

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/18/2006
Last Update Date	:	02/25/2021

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Directions to “ MINH T TRAN D.O.” Practice Location

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