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NPI Code Detail

MEDICARE: RICHARD PHONG VU M.D.

MEDICARE:   RICHARD PHONG VU  M.D.
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
1207R00000XInternal Medicine Physician42318CO

Other Identifiers

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

General Provider Information

NPI Number : 1316930241
Entity Type Code : Individual
Provider Name (Legal Business Name) : RICHARD PHONG VU M.D.
Provider Business Mailing Address
First Line : 4190 E WOODMEN RD
Second Line : SUITE 100
City : COLORADO SPRINGS
State : CO
Zip : 80920-8075
Country : US
Telephone Number : 719-632-4455
Fax Number : 719-633-6413
Provider Business Practice Location Address
First Line : 4190 E WOODMEN RD
Second Line : SUITE 100
City : COLORADO SPRINGS
State : CO
Zip : 80920-8075
Country : US
Telephone Number : 719-632-4455
Fax Number : 719-633-6413
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/25/2005
Last Update Date : 05/01/2013

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Directions to “ RICHARD PHONG VU M.D.” Practice Location

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