Basic Information
| Provider Information | |||||||||
| NPI: | 1326661265 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | DO-NGUYEN | ||||||||
| FirstName: | CHI CHI | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | DO | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1500 E MEDICAL CENTER DRIVE, SPC 5856 | ||||||||
| Address2: | FCVC 3RD FLOOR, RECEPTION C | ||||||||
| City: | ANN ARBOR | ||||||||
| State: | MI | ||||||||
| PostalCode: | 481095856 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7346477321 | ||||||||
| FaxNumber: | 7343625236 | ||||||||
| Practice Location | |||||||||
| Address1: | 1500 E MEDICAL CENTER DRIVE, SPC 5856 | ||||||||
| Address2: | FCVC 3RD FLOOR, RECEPTION C | ||||||||
| City: | ANN ARBOR | ||||||||
| State: | MI | ||||||||
| PostalCode: | 481095856 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7346477321 | ||||||||
| FaxNumber: | 7343625236 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/27/2020 | ||||||||
| LastUpdateDate: | 05/25/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 05/25/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 390200000X | N | Student, Health Care | Student in an Organized Health Care Education/Training Program | 390200000X | 5151014749 | MI | Y | Student, Health Care | Student in an Organized Health Care Education/Training Program |
No ID Information.