Provider Demographics
NPI:1962441998
Name:NGUYEN, HAO D (DO)
Entity type:Individual
Prefix:
First Name:HAO
Middle Name:D
Last Name:NGUYEN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4614 S LABADIE
Mailing Address - Street 2:
Mailing Address - City:MILFORD
Mailing Address - State:MI
Mailing Address - Zip Code:48380-3026
Mailing Address - Country:US
Mailing Address - Phone:248-245-6129
Mailing Address - Fax:248-957-8234
Practice Address - Street 1:28481 7 MILE RD
Practice Address - Street 2:
Practice Address - City:LIVONIA
Practice Address - State:MI
Practice Address - Zip Code:48152-3501
Practice Address - Country:US
Practice Address - Phone:248-759-8233
Practice Address - Fax:248-957-8234
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-05
Last Update Date:2024-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5101015612207P00000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI5101015612OtherPHYSICIAN LICENSE