| Doctor Name: | DR. CUONG MANH NGUYEN |
| NPI Number: | 1316009095 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | DO |
| License Number: | 02003017A |
| Business Practice Address: | 105 Grant Cir Ste 133 Offutt Afb, NE - 681134041 |
| Business Phone Number: | 4022949022 |
| Business Fax Number: | |
| Mailing Address: | 2911 Washington St Apt 16, BELLEVUE |
| State: | NE |
| Postal Code: | 680055621 |
| Phone Number: | 7073862437 |
| Fax Number: | |
| NPI Enumeration Date: | 12/15/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | 02003017A |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | IN |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |