Provider Demographics
NPI:1194857185
Name:NGUYEN, QUANG VINH (DO)
Entity type:Individual
Prefix:
First Name:QUANG
Middle Name:VINH
Last Name:NGUYEN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:601 MEMORY LN
Mailing Address - Street 2:
Mailing Address - City:YORK
Mailing Address - State:PA
Mailing Address - Zip Code:17402-2231
Mailing Address - Country:US
Mailing Address - Phone:717-851-1405
Mailing Address - Fax:
Practice Address - Street 1:1001 S GEORGE ST
Practice Address - Street 2:
Practice Address - City:YORK
Practice Address - State:PA
Practice Address - Zip Code:17403-3676
Practice Address - Country:US
Practice Address - Phone:717-851-4005
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-12
Last Update Date:2024-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS013885207R00000X, 208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD034078200Medicaid
PA211399OtherJOHNS HOPKINS
PA30131833OtherAMERIHEALTH MERCY - WMG
PA50070970OtherCAPITAL BLUE CROSS-WMG
MD897872OtherCAREFIRST MD BCBS
PA217504OtherUNISON-WMG
PA1563747OtherGATEWAY-WMG
2161248OtherMAMSI-WMG
PA9123073OtherAETNA
PA111164OtherGEISINGER
PA1973178OtherHIGHMARK BLUE SHIELD
PA101938390Medicaid
PA20090414OtherAMERIHEALTH MERCY
PA30131833OtherAMERIHEALTH MERCY - WMG
PA113226EZ3Medicare PIN