MEDICARE: HIEN QUANG NGUYEN 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	208600000X	Surgery Physician	D0057210	MD
2	207Q00000X	Family Medicine Physician	C1-0011106	DE

Other Identifiers

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

General Provider Information

NPI Number	:	1629053046
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HIEN QUANG NGUYEN MD

Provider Business Mailing Address
First Line	:	101 CHESAPEAKE BLVD STE B
Second Line	:
City	:	ELKTON
State	:	MD
Zip	:	21921-6607
Country	:	US
Telephone Number	:	410-398-0590
Fax Number	:	410-392-4524

Provider Business Practice Location Address
First Line	:	379 WALMART DR
Second Line	:
City	:	CAMDEN
State	:	DE
Zip	:	19934-1365
Country	:	US
Telephone Number	:	302-387-4343
Fax Number	:

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

Provider Enumeration Date	:	12/08/2005
Last Update Date	:	03/30/2021

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Directions to “ HIEN QUANG NGUYEN MD” Practice Location

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