Provider Demographics
NPI:1518034826
Name:NGUYEN, MYHANH J (MD)
Entity type:Individual
Prefix:
First Name:MYHANH
Middle Name:J
Last Name:NGUYEN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:90 SWIFTWATER RD
Mailing Address - Street 2:
Mailing Address - City:WOODSVILLE
Mailing Address - State:NH
Mailing Address - Zip Code:03785-1421
Mailing Address - Country:US
Mailing Address - Phone:603-436-5110
Mailing Address - Fax:
Practice Address - Street 1:333 BORTHWICK AVE
Practice Address - Street 2:
Practice Address - City:PORTSMOUTH
Practice Address - State:NH
Practice Address - Zip Code:03801
Practice Address - Country:US
Practice Address - Phone:603-463-5110
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-29
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH13553208M00000X, 207R00000X
MEMD23141208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME1518034826Medicaid
NHP00673146OtherRR MEDICARE
NH3074815Medicaid
NH3074815Medicaid