Individual
AN NGUYEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4130 BRETON RD SE, KENTWOOD, MI 49512-3807
(616) 281-0093
(616) 281-0580
Mailing address
4130 BRETON RD SE, KENTWOOD, MI 49512-3807
(616) 281-0093
(616) 281-0580
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
4301056463
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2995085
—
MI
05
—
3415770
—
MI
05
—
4155595
—
MI
05
—
4194172
—
MI
05
—
4878918
—
MI
Enumeration date
05/26/2006
Last updated
06/26/2021
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