1265938120 NPI number — TRI NGUYEN DO

Table of content: TRI NGUYEN DO (NPI 1265938120)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1265938120 NPI number — TRI NGUYEN DO

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
NGUYEN
Provider First Name:
TRI
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
DO
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1265938120
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/15/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
UNIVERSITY OF MICHIGAN'S GRADUATE MEDICAL EDUCATION
Provider Second Line Business Mailing Address:
2600 GREEN ROAD, SUITE 150-B, SPC 5791
Provider Business Mailing Address City Name:
ANN ARBOR
Provider Business Mailing Address State Name:
MI
Provider Business Mailing Address Postal Code:
48105
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
734-764-3186
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2600 GREEN RD STE 150-B
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ANN ARBOR
Provider Business Practice Location Address State Name:
MI
Provider Business Practice Location Address Postal Code:
48105-4631
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
734-764-3186
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
03/31/2018

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207RS0012X , with the licence number:  5101027878 , registered in the state of MI ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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