Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 204F00000X | Transplant Surgeon | 47549 | MN |
N | 208200000X | Surgeon | 47549 | MN |
N | 208600000X | Surgeon | 47549 | MN |
Y | 208200000X | Surgeon | ME99639 | FL |
Y | 208600000X | Surgeon | ME99639 | FL |
NPI | 1487727376 |
---|---|
Provider Name | Dr. Thanh Hang Khac Nguyen |
First Address | Tampa, FL 33609 |
Second Address | Tampa, FL 33609 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/11/2006 |
Last Update Date | 29/08/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
805T5NG | BLUE CROSS BLUE SHIELD (01) |