Individual
THI BUI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
11109 PARKVIEW PLAZA DR, FORT WAYNE, IN 46845
(260) 672-6620
(260) 672-6639
Mailing address
11109 PARKVIEW PLAZA DR # 117, FORT WAYNE, IN 46845-1701
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
02005472A
IN
Other
Enumeration date
05/11/2015
Last updated
10/11/2022
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