MEDICARE: DR. TU HUU 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	207R00000X	Internal Medicine Physician	0101035508	VA

General Provider Information

NPI Number	:	1881672921
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. TU HUU NGUYEN M.D.

Provider Business Mailing Address
First Line	:	PO BOX 4030
Second Line	:
City	:	PETERSBURG
State	:	VA
Zip	:	23803-0030
Country	:	US
Telephone Number	:	804-524-7294
Fax Number	:	804-524-7030

Provider Business Practice Location Address
First Line	:	26317 WEST WASHINGTON ST. EXT.
Second Line	:
City	:	PETERSBURG
State	:	VA
Zip	:	23803-0030
Country	:	US
Telephone Number	:	804-524-7294
Fax Number	:	804-524-7030

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

Provider Enumeration Date	:	01/09/2006
Last Update Date	:	07/08/2007

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