Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QA0401X | Family Doctor - Addiction Medicine | 077860 | OH |
NPI | 1366706673 |
---|---|
Provider Name | Dr. Thomas Anh Nguyen |
First Address | Cincinnati, OH 45219-2498 |
Second Address | Cincinnati, OH 45219-2498 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 02/07/2012 |
Last Update Date | 02/07/2012 |