Provider Demographics
NPI:1215953054
Name:VUONG, TRANG (MD)
Entity type:Individual
Prefix:
First Name:TRANG
Middle Name:
Last Name:VUONG
Suffix:
Gender:F
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:PO BOX 60447
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28260-0447
Mailing Address - Country:US
Mailing Address - Phone:704-316-1040
Mailing Address - Fax:704-316-1041
Practice Address - Street 1:9955 POPLAR TENT RD
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:NC
Practice Address - Zip Code:28027-9304
Practice Address - Country:US
Practice Address - Phone:704-316-1161
Practice Address - Fax:704-316-1162
Is Sole Proprietor?:No
Enumeration Date:2006-07-14
Last Update Date:2020-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC200600431208000000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC5903791Medicaid
NC2054278Medicare PIN
NC2054278AMedicare PIN
H15277Medicare UPIN