Basic Information
Provider Information
NPI: 1023235884
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: DO
FirstName: VIET
MiddleName: HUU
NamePrefix:  
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1111 LEFFINGWELL AVE NE
Address2: SUITE 200
City: GRAND RAPIDS
State: MI
PostalCode: 495256406
CountryCode: US
TelephoneNumber: 6164597101
FaxNumber:  
Practice Location
Address1: 1111 LEFFINGWELL NE
Address2: SUITE 200
City: GRAND RAPIDS
State: MI
PostalCode: 495256406
CountryCode: US
TelephoneNumber: 6164597101
FaxNumber:  
Other Information
ProviderEnumerationDate: 04/20/2007
LastUpdateDate: 01/29/2013
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207XS0106X4301088528MIN Allopathic & Osteopathic PhysiciansOrthopaedic SurgeryHand Surgery
2086S0122X4301088528MIY Allopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive Surgery

No ID Information.


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