Doctor Name: | BANG TU NGUYEN |
NPI Number: | 1528028545 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | MD |
License Number: | I4949 |
Business Practice Address: | 711 South Vine Street Glenwood, IA - 515341927 |
Business Phone Number: | 7125274811 |
Business Fax Number: | 7125272270 |
Mailing Address: | 711 South Vine Street, GLENWOOD |
State: | IA |
Postal Code: | 515341927 |
Phone Number: | 7125274811 |
Fax Number: | 7125272270 |
NPI Enumeration Date: | 03/24/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | I4949 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IA |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |