Individual
TAM NGUYEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
1550 MIDWAY PL, MENASHA, WI 54952-1165
(920) 738-2000
Mailing address
1550 MIDWAY PL, MENASHA, WI 54952-1165
(920) 738-2000
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
81269
WI
207ND0101X
MOHS-Micrographic Surgery Physician
81269
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100281230
—
WI
Enumeration date
03/20/2019
Last updated
05/22/2025
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