Provider Demographics
NPI:1396703625
Name:VUONG, DUC C (MD)
Entity type:Individual
Prefix:MR
First Name:DUC
Middle Name:C
Last Name:VUONG
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:4801 MCMAHON BLVD NW
Mailing Address - Street 2:245
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87114-5090
Mailing Address - Country:US
Mailing Address - Phone:505-727-2300
Mailing Address - Fax:505-727-2463
Practice Address - Street 1:4801 MCMAHON BLVD NW
Practice Address - Street 2:245
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87114-5090
Practice Address - Country:US
Practice Address - Phone:505-727-2300
Practice Address - Fax:505-727-2463
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-03
Last Update Date:2017-02-02
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TXM0961174400000X
NMMD2010-0595208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM48729779Medicaid
TX8F1504Medicare ID - Type Unspecified
NM48729779Medicaid