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Individual

MINHTAM T THAI

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
DPM

Contact information

Practice address
4106 PORTSMOUTH BLVD, PORTSMOUTH, VA 23701
(757) 393-1136
(757) 698-2499
Mailing address
1395 NW 167TH ST, MIAMI GARDENS, FL 33169-5710
(305) 628-6117

Taxonomy

Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
0103301001
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0103301001
COMMONWEALTH OF VIRGINIA
VA
Enumeration date
01/31/2009
Last updated
10/24/2019
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