Individual
DZUNG V. NGUYEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
6439 GARNERS FERRY RD, COLUMBIA, SC 29209-1638
(803) 776-4000
Mailing address
6439 GARNERS FERRY RD, COLUMBIA, SC 29209-1638
(803) 776-4000
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
036094757
IL
207L00000X
Anesthesiology Physician
Primary
G73101
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036094757
—
IL
01
—
364138353
TAX ID
IL
01
—
400130
GROUP MEDICARE PTAN
—
01
—
CN4921
RRMC
—
Enumeration date
08/28/2006
Last updated
02/03/2017
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