Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208200000X | Surgeon | 01082767A | IN |
Y | 208600000X | Surgeon | 01082767A | IN |
N | 208200000X | Surgeon | A148007 | CA |
N | 208600000X | Surgeon | A148007 | CA |
N | 2086X0206X | Surgical Oncologist | A148007 | CA |
NPI | 1275708653 |
---|---|
Provider Name | Trang Kim Nguyen |
First Address | Indianapolis, IN 46202-5112 |
Second Address | Indianapolis, IN 46202-5116 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/04/2008 |
Last Update Date | 25/01/2021 |