Individual
PHONG NGUYEN KIEU
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
123 SUMMER ST STE 320S, WORCESTER, MA 01608-1216
(508) 964-5580
(508) 368-3143
Mailing address
123 SUMMER ST STE 320S, WORCESTER, MA 01608-1216
(508) 964-5580
(508) 368-3143
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
254817
MA
2081S0010X
Sports Medicine (Physical Medicine & Rehabilitation) Physician
Primary
254817
MA
Other
Enumeration date
06/03/2008
Last updated
05/22/2024
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