Individual
DICH VAN NGUYEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4865 LAVISTA RD, TUCKER, GA 30084-4436
(770) 270-0290
(770) 723-0598
Mailing address
PO BOX 29528, ATLANTA, GA 30359
(404) 766-4633
(404) 766-1108
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
036656
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000614116C
—
GA
Enumeration date
06/27/2006
Last updated
12/02/2010
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