Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0102X | Surgical Critical Care | 076300 | GA |
N | 208D00000X | General Practice Physician | 208D00000X | NJ |
NPI | 1285945428 |
---|---|
Provider Name | Dr. Jonathan Huy Nguyen |
First Address | Atlanta, GA 30310-1458 |
Second Address | Atlanta, GA 30303-3031 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/06/2010 |
Last Update Date | 23/06/2021 |