Provider Demographics
NPI:1215452065
Name:TRAN, JOHN (DPM)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:
Last Name:TRAN
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:19723 ALLEN RD
Mailing Address - Street 2:
Mailing Address - City:BROWNSTOWN TWP
Mailing Address - State:MI
Mailing Address - Zip Code:48183-1021
Mailing Address - Country:US
Mailing Address - Phone:734-479-8383
Mailing Address - Fax:734-479-8382
Practice Address - Street 1:19723 ALLEN RD
Practice Address - Street 2:
Practice Address - City:BROWNSTOWN TWP
Practice Address - State:MI
Practice Address - Zip Code:48183-1021
Practice Address - Country:US
Practice Address - Phone:734-479-8383
Practice Address - Fax:734-479-8382
Is Sole Proprietor?:No
Enumeration Date:2017-08-12
Last Update Date:2021-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMT-1875213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist