Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 5101016741 | MI |
N | 111NI0900X | Internist | 5101016741 | MI |
Y | 207RC0000X | Internist - Cardiovascular Disease | 036135508 | IL |
N | 207RC0001X | Clinical Cardiac Electrophysiologist | 5101016741 | MI |
N | 207RC0001X | Clinical Cardiac Electrophysiologist | 57239-21 | WI |
NPI | 1093933665 |
---|---|
Provider Name | Binh T Nguyen |
First Address | Saint Louis, MO 63195-2217 |
Second Address | Pontiac, MI 48342-2217 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/04/2007 |
Last Update Date | 29/10/2020 |