Individual
QUANG HUY VU TRAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
605 BEAVER RUIN RD NW STE C, LILBURN, GA 30047-3430
(573) 821-0352
Mailing address
1157 HALLETTS PEAK PL, LAWRENCEVILLE, GA 30044-0105
(404) 723-3471
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
10972
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10972
PHYSICIAN ASSISTANT STATE LICENSE
GA
Enumeration date
04/12/2022
Last updated
05/29/2024
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