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Individual

DR. BACH VAN NGUYEN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
828 SNYDER AVE, PHILADELPHIA, PA 19148-2310
(215) 755-8220
(215) 755-8692
Mailing address
30 OLD STATE RD, BERWYN, PA 19312-1125
(610) 688-3184

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
MD-039485L
PA
207R00000X
Internal Medicine Physician
Primary
MD-039485L
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
001123542
MEDICAL ASSISTANCE
PA
05
001123542-0003
PA
Enumeration date
06/27/2005
Last updated
03/22/2016
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