MEDICARE: ANTHONY NGUYEN DO

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	207K00000X	Allergy & Immunology Physician	H0079500	MD
2	207K00000X	Allergy & Immunology Physician	34.016196	OH
3	207K00000X	Allergy & Immunology Physician	OP60856014	WA
4	208000000X	Pediatrics Physician	125058267	IL
5	207K00000X	Allergy & Immunology Physician	DO3737	NV

General Provider Information

NPI Number	:	1841519915
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANTHONY NGUYEN DO

Provider Business Mailing Address
First Line	:	PO BOX 603725
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28260-3725
Country	:	US
Telephone Number	:	828-575-2625
Fax Number	:	828-350-2174

Provider Business Practice Location Address
First Line	:	6080 S FORT APACHE RD STE 110
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89148-5616
Country	:	US
Telephone Number	:	702-268-2820
Fax Number	:

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

Provider Enumeration Date	:	05/27/2010
Last Update Date	:	09/13/2024

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