Provider Demographics
NPI:1235492869
Name:NGUYEN, MIEN HAI (DO)
Entity type:Individual
Prefix:
First Name:MIEN
Middle Name:HAI
Last Name:NGUYEN
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1601 SAINT FRANCIS AVE STE 100
Mailing Address - Street 2:
Mailing Address - City:SHAKOPEE
Mailing Address - State:MN
Mailing Address - Zip Code:55379-3384
Mailing Address - Country:US
Mailing Address - Phone:952-428-3535
Mailing Address - Fax:
Practice Address - Street 1:1601 SAINT FRANCIS AVE STE 100
Practice Address - Street 2:
Practice Address - City:SHAKOPEE
Practice Address - State:MN
Practice Address - Zip Code:55379-3384
Practice Address - Country:US
Practice Address - Phone:952-428-3535
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-06-19
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5101020025207R00000X
MN61921207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine