Individual
DR. THANH NGUYEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1200 NORTHSIDE FORSYTH DR, CUMMING, GA 30041-7659
(770) 844-3200
(770) 844-3227
Mailing address
PO BOX 742616, ATLANTA, GA 30374-2616
(770) 219-8420
(770) 219-8440
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
057733
GA
208M00000X
Hospitalist Physician
Primary
57733
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
202G701483
MEDICARE GROUP PTAN
GA
Enumeration date
06/22/2006
Last updated
01/10/2020
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