Individual
THANG XUAN NGUYEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1360 S MAIN ST, ELLIJAY, GA 30540-5410
(706) 515-4038
Mailing address
404 AFTER GLOW SMT, CANTON, GA 30114-5715
(212) 479-9566
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
27172
OK
Other
Enumeration date
05/26/2009
Last updated
06/11/2021
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