Individual
JEREMY B NGUYEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1111 MEDICAL CENTER BLVD, SUITE N-108, MARRERO, LA 70072-3151
(504) 349-1461
(504) 349-1470
Mailing address
1101 MEDICAL CENTER BLVD, RADIOLOGY DEPT, MARRERO, LA 70072-3147
(504) 349-1461
(504) 349-1470
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
200373
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
009941591
—
AL
05
—
01084889
—
MS
05
—
1576239
—
LA
05
—
182370001
—
TX
01
—
586402327
TRICARE
—
01
—
8W2044
BCBSTX
TX
01
—
P00377885
RAILROAD MEDICARE
GA
Enumeration date
07/04/2006
Last updated
08/06/2008
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