MEDICARE: THY NGUYEN MD LLC

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	207Q00000X	Family Medicine Physician	D0066660	MD

General Provider Information

NPI Number	:	1912297797
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THY NGUYEN MD LLC

Provider Business Mailing Address
First Line	:	10600 YORK RD
Second Line	:	STE 102
City	:	COCKEYSVILLE
State	:	MD
Zip	:	21030-2351
Country	:	US
Telephone Number	:	443-318-4141
Fax Number	:

Provider Business Practice Location Address
First Line	:	10600 YORK RD
Second Line	:	STE 102
City	:	COCKEYSVILLE
State	:	MD
Zip	:	21030-2351
Country	:	US
Telephone Number	:	443-318-4141
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	DR. THY B NGUYEN
Credential	:	M.D.
Telephone Number	:	443-318-4141

Provider Enumeration Date	:	04/13/2011
Last Update Date	:	04/14/2011

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