Provider Demographics
NPI:1154346658
Name:BARTHOLOMEW, HUYEN NGOC T (MD)
Entity type:Individual
Prefix:
First Name:HUYEN NGOC
Middle Name:T
Last Name:BARTHOLOMEW
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:HUYEN NGOC
Other - Middle Name:TRANBERG
Other - Last Name:BARTHOLOMEW
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:1031 PIERCE ST
Mailing Address - Street 2:SUITE
Mailing Address - City:SANDUSKY
Mailing Address - State:OH
Mailing Address - Zip Code:44870-4669
Mailing Address - Country:US
Mailing Address - Phone:419-557-5568
Mailing Address - Fax:419-557-5542
Practice Address - Street 1:1605 STATE ROUTE 60
Practice Address - Street 2:VINEYARD SQUARE PLAZA #9
Practice Address - City:VERMILION
Practice Address - State:OH
Practice Address - Zip Code:44089
Practice Address - Country:US
Practice Address - Phone:440-967-1128
Practice Address - Fax:440-967-1172
Is Sole Proprietor?:No
Enumeration Date:2006-07-13
Last Update Date:2023-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35097630207Q00000X
OH35.097630207P00000X
MN39446207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MNG37848Medicare UPIN