Provider Demographics
NPI:1790679272
Name:NGUYEN, KEVIN DUC
Entity type:Individual
Prefix:MR
First Name:KEVIN
Middle Name:DUC
Last Name:NGUYEN
Suffix:
Gender:M
Credentials:
Other - Prefix:MR
Other - First Name:NGUYEN-TUONG
Other - Middle Name:DUC
Other - Last Name:NGUYEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:30 THURMAN PARK
Mailing Address - Street 2:
Mailing Address - City:EVERETT
Mailing Address - State:MA
Mailing Address - Zip Code:02149-4107
Mailing Address - Country:US
Mailing Address - Phone:781-242-2808
Mailing Address - Fax:
Practice Address - Street 1:30 THURMAN PARK
Practice Address - Street 2:
Practice Address - City:EVERETT
Practice Address - State:MA
Practice Address - Zip Code:02149-4107
Practice Address - Country:US
Practice Address - Phone:781-242-2808
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-07
Last Update Date:2025-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes347E00000XTransportation ServicesTransportation Broker