Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207KA0200X | Allergist | C1-0002745 | DE |
NPI | 1144258120 |
---|---|
Provider Name | Dr. Quan Chung Nguyen |
First Address | Newark, DE 19713-6109 |
Second Address | Newark, DE 19713-6109 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 29/06/2006 |
Last Update Date | 17/08/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0000040501 | (05) | DE |
0108315000 | HIGHMARK BCBS (01) | DE |
030004391 | RAILROAD MEDICARE (01) | DE |
1145968B | CIGNA (01) | DE |
1730 | COVENTRY (01) | DE |
4259775 | AETNA (01) | DE |
480074 | AMERIHEATH (01) | DE |
C78741 | (02) | DE |