Individual
JOHNATHAN THOMAS NGUYEN ULRICH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1120 15TH ST, AUGUSTA, GA 30912-0004
(706) 721-0211
Mailing address
11553 LUCASVILLE RD, MANASSAS, VA 20112-4422
(571) 606-1718
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
07/15/2025
Last updated
07/15/2025
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