Basic Information
| Provider Information | |||||||||
| NPI: | 1952382517 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | NGUYEN | ||||||||
| FirstName: | TRINH | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | DO | ||||||||
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| Mailing Information | |||||||||
| Address1: | 401 S BALLENGER HWY | ||||||||
| Address2: | |||||||||
| City: | FLINT | ||||||||
| State: | MI | ||||||||
| PostalCode: | 485323638 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8103421000 | ||||||||
| FaxNumber: | 8103421590 | ||||||||
| Practice Location | |||||||||
| Address1: | 2316 S CEDAR ST | ||||||||
| Address2: | |||||||||
| City: | LANSING | ||||||||
| State: | MI | ||||||||
| PostalCode: | 489103152 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5177024130 | ||||||||
| FaxNumber: | 5177024139 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/10/2005 | ||||||||
| LastUpdateDate: | 01/29/2016 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | 5101011389 | MI | Y | Allopathic & Osteopathic Physicians | Family Medicine |
ID Information
| ID | Type | State | Issuer | Description | 0100309 | 01 | MI | PHYSICIANS HEALTH PLAN | OTHER | 080D410020 | 01 | MI | COMMUNITY BLUE PPO | OTHER | 4627071 | 01 | MI | AETNA | OTHER | 4723825 | 05 | MI | MEDICAID | 080D410020 | 01 | MI | BLUE CROSS BLUE SHIELD | OTHER | 0853301474 | 01 | MI | BLUE CROSS BLUE SHIELD | OTHER | 080D410020 | 01 | MI | BLUE CHOICE | OTHER | 201481 | 01 | MI | HEALTH ADVANTAGE NETWORK | OTHER | 4511340 | 05 | MI | MEDICAID | 201481 | 01 | MI | MCLAREN HEALTH PLAN | OTHER | 4162894 | 05 | MI | MEDICAID | F67647 | 01 | MI | HEALTH NET FED SERVICES | OTHER | 080D410020 | 01 | MI | BLUE CARE NETWORK | OTHER |