MEDICARE: TAM MINH NGUYEN 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
1	208VP0000X	Pain Medicine Physician	DR.0058865	CO
2	207L00000X	Anesthesiology Physician	DR.0058865	CO

General Provider Information

NPI Number	:	1497010573
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TAM MINH NGUYEN M.D.

Provider Business Mailing Address
First Line	:	7913 ALLISON WAY STE 201
Second Line	:
City	:	ARVADA
State	:	CO
Zip	:	80005-4450
Country	:	US
Telephone Number	:	303-844-5000
Fax Number	:	844-829-5015

Provider Business Practice Location Address
First Line	:	9351 GRANT ST STE 490
Second Line	:
City	:	THORNTON
State	:	CO
Zip	:	80229-4365
Country	:	US
Telephone Number	:	303-844-5000
Fax Number	:	844-829-5015

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

Provider Enumeration Date	:	07/05/2012
Last Update Date	:	04/21/2021

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