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NPI Code Detail

MEDICARE: KHANH TUAN VU M.D.

MEDICARE: KHANH TUAN 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
1207Q00000XFamily Medicine Physician36447NC

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 : 1679570717
Entity Type Code : Individual
Provider Name (Legal Business Name) : KHANH TUAN VU M.D.
Provider Business Mailing Address
First Line : 381 RUIN CREEK RD
Second Line :
City : HENDERSON
State : NC
Zip : 27536-2932
Country : US
Telephone Number : 252-430-0666
Fax Number : 252-430-7503
Provider Business Practice Location Address
First Line : 381 RUIN CREEK RD
Second Line :
City : HENDERSON
State : NC
Zip : 27536-2932
Country : US
Telephone Number : 252-430-0666
Fax Number : 252-430-7503
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/05/2005
Last Update Date : 10/23/2020

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Directions to “ KHANH TUAN VU M.D.” Practice Location

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