Individual
UY QUOC VU
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
631 PROFESSIONAL DR, SUITE 120, LAWRENCEVILLE, GA 30046-3367
(678) 312-3290
(678) 312-2733
Mailing address
631 PROFESSIONAL DR STE 120, LAWRENCEVILLE, GA 30046-3370
(678) 312-3290
(678) 312-2733
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
053628
GA
2086S0102X
Surgical Critical Care Physician
Primary
053628
GA
2086S0127X
Trauma Surgery Physician
053628
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
053628
MEDICAL LICENSE - ACTIVE
GA
Enumeration date
07/19/2006
Last updated
03/07/2023
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