Individual
MS. KIM LOAN T NGUYEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
20 GLENLAKE PKWY, KAISER PERMANENTE GLENLAKE, ATLANTA, GA 30328-3473
(269) 349-2266
(269) 349-0792
Mailing address
3495 PIEDMONT RD NE, NINE PIEDMONT CENTER, ATLANTA, GA 30305-1717
(404) 364-7070
(269) 349-0792
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
067515
GA
207RG0100X
Gastroenterology Physician
KN080415
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1003913802
BLUE CROSS BLUE SHIELD
MI
05
—
105371914
—
MI
01
—
1851569958
NPI FOR DIGESTIVE HEALTH ASSOCIATE
MI
01
—
261859452
TAX ID FOR DIGESTIVE HEALTH ASSOCIATES OF SW MI
MI
01
—
4301080415
STATE LICENSE NUMBER
MI
Enumeration date
08/17/2007
Last updated
01/07/2022
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