Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207P00000X | Emergency Physician | 35 044048N | OH |
Y | 207QA0401X | Family Doctor - Addiction Medicine | 35-044048 | OH |
NPI | 1073500039 |
---|---|
Provider Name | Dr. Harry P Nguyen |
First Address | Worthington, OH 43085-2940 |
Second Address | Columbus, OH 43235 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 04/10/2005 |
Last Update Date | 28/11/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
311216961 00 | BWC (01) | OH |
D31260 | (02) |