Provider Demographics
NPI:1306261243
Name:MINH THIEU, MD, PC
Entity type:Organization
Organization Name:MINH THIEU, MD, PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MINH
Authorized Official - Middle Name:P
Authorized Official - Last Name:THIEU
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:215-605-8534
Mailing Address - Street 1:109 N EAGLE RD
Mailing Address - Street 2:SUITE 2
Mailing Address - City:HAVERTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:19083-3400
Mailing Address - Country:US
Mailing Address - Phone:610-789-7546
Mailing Address - Fax:610-789-7547
Practice Address - Street 1:109 N EAGLE RD
Practice Address - Street 2:SUITE 2
Practice Address - City:HAVERTOWN
Practice Address - State:PA
Practice Address - Zip Code:19083-3400
Practice Address - Country:US
Practice Address - Phone:610-789-7546
Practice Address - Fax:610-789-7547
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-03-02
Last Update Date:2015-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Single Specialty