Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213ES0131X | Foot Surgery | 729 | SC |
NPI | 1033606868 |
---|---|
Provider Name | Thomas D. Nguyen |
First Address | West Columbia, SC 29171-6069 |
Second Address | Columbia, SC 29229-7849 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 17/04/2018 |
Last Update Date | 26/07/2021 |