Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207K00000X | Allergist & Immunologist | 4341 | IA |
N | 207R00000X | Internist | R9217 | IA |
N | 111NI0900X | Internist | R9217 | IA |
NPI | 1174817134 |
---|---|
Provider Name | Dr. Vuong Anh Nayima |
First Address | West Des Moines, IA 50266-8297 |
Second Address | West Des Moines, IA 50266-8297 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/06/2011 |
Last Update Date | 29/04/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0123134 | (05) | IA |
IB4258001 | MEDICARE IA (01) | IA |
P02168477 | MEDICARE RR (01) |