MEDICARE: NGOC BAO NGUYEN DO, MPH

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	2083P0901X	Public Health & General Preventive Medicine Physician	C2-0024979	DE

General Provider Information

NPI Number	:	1497457253
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NGOC BAO NGUYEN DO, MPH

Provider Business Mailing Address
First Line	:	3565 PHILADELPHIA PIKE
Second Line	:
City	:	CLAYMONT
State	:	DE
Zip	:	19703-3106
Country	:	US
Telephone Number	:	302-320-4110
Fax Number	:	302-798-6672

Provider Business Practice Location Address
First Line	:	3565 PHILADELPHIA PIKE
Second Line	:
City	:	CLAYMONT
State	:	DE
Zip	:	19703-3106
Country	:	US
Telephone Number	:	302-320-4110
Fax Number	:	302-798-6672

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

Provider Enumeration Date	:	03/17/2023
Last Update Date	:	06/11/2026

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