MEDICARE: THANH-TRUC THUY DOAN MD

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	208000000X	Pediatrics Physician	2020-00311	NC
2	208M00000X	Hospitalist Physician	2020-00311	NC

General Provider Information

NPI Number	:	1467839670
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	THANH-TRUC THUY DOAN MD

Provider Business Mailing Address
First Line	:	PO BOX 19305
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28219-9305
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1001 BLYTHE BLVD
Second Line	:	MEDICAL CENTER PLAZA SUITE 200
City	:	CHARLOTTE
State	:	NC
Zip	:	28203-5866
Country	:	US
Telephone Number	:	704-381-8840
Fax Number	:

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

Provider Enumeration Date	:	04/27/2015
Last Update Date	:	12/30/2025

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