MEDICARE: DR. PETER TUAN ANH VU OD

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	152W00000X	Optometrist	1886-821AT	LA

General Provider Information

NPI Number	:	1225519655
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. PETER TUAN ANH VU OD

Provider Business Mailing Address
First Line	:	2435 COMMERCE AVE BLDG 2200
Second Line	:
City	:	DULUTH
State	:	GA
Zip	:	30096-4980
Country	:	US
Telephone Number	:	687-071-2504
Fax Number	:

Provider Business Practice Location Address
First Line	:	8814 VETERANS MEMORIAL BLVD STE 1
Second Line	:
City	:	METAIRIE
State	:	LA
Zip	:	70003-5264
Country	:	US
Telephone Number	:	507-712-6870
Fax Number	:

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

Provider Enumeration Date	:	08/23/2018
Last Update Date	:	08/23/2018

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