Provider Demographics
NPI:1538234331
Name:VUONG, PHUONG HOANG (MD)
Entity type:Individual
Prefix:
First Name:PHUONG
Middle Name:HOANG
Last Name:VUONG
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 1:200 MEDICAL CENTER DR
Mailing Address - Street 2:SUITE 180B
Mailing Address - City:MIDDLETOWN
Mailing Address - State:OH
Mailing Address - Zip Code:45005-5200
Mailing Address - Country:US
Mailing Address - Phone:513-420-8030
Mailing Address - Fax:513-425-7202
Practice Address - Street 1:200 MEDICAL CENTER DR
Practice Address - Street 2:SUITE 180B
Practice Address - City:MIDDLETOWN
Practice Address - State:OH
Practice Address - Zip Code:45005-5200
Practice Address - Country:US
Practice Address - Phone:513-420-8030
Practice Address - Fax:513-425-7202
Is Sole Proprietor?:No
Enumeration Date:2006-11-21
Last Update Date:2013-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35056968207R00000X, 207RC0200X, 207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0723391Medicaid
D98035Medicare UPIN
OH9927981Medicare ID - Type Unspecified
OH0723391Medicaid