Provider Demographics
NPI:1194710061
Name:NGUYEN, HIEU JOE VAN (MD)
Entity type:Individual
Prefix:
First Name:HIEU JOE
Middle Name:VAN
Last Name:NGUYEN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1200 6TH AVE N
Mailing Address - Street 2:
Mailing Address - City:SAINT CLOUD
Mailing Address - State:MN
Mailing Address - Zip Code:56303-2735
Mailing Address - Country:US
Mailing Address - Phone:320-252-5131
Mailing Address - Fax:320-240-2118
Practice Address - Street 1:1200 6TH AVE N
Practice Address - Street 2:
Practice Address - City:SAINT CLOUD
Practice Address - State:MN
Practice Address - Zip Code:56303-2735
Practice Address - Country:US
Practice Address - Phone:320-252-5131
Practice Address - Fax:320-255-5714
Is Sole Proprietor?:No
Enumeration Date:2005-09-15
Last Update Date:2024-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN42011207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
123615OtherUCARE
MN507824500Medicaid
1020102OtherPREFERRED ONE
2021155OtherFIRST HEALTH PLAN
2511540OtherMEDICA HEALTH PLANS
847392OtherARAZ GROUP AMERICAS PPO
68D57NGOtherBLUE CROSS BLUE SHIELD
507824500OtherMEDICAL ASSISTANCE
HP29109OtherHEALTH PARTNERS
123615OtherUCARE
2511540OtherMEDICA HEALTH PLANS