Basic Information
| Provider Information | |||||||||
| NPI: | 1528795887 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | HUYNH | ||||||||
| FirstName: | MAI-LINH | ||||||||
| MiddleName: | THI | ||||||||
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| Credential: | PA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 11003 DAVID STONE DR | ||||||||
| Address2: | |||||||||
| City: | CHAPEL HILL | ||||||||
| State: | NC | ||||||||
| PostalCode: | 275177416 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3363377343 | ||||||||
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| Practice Location | |||||||||
| Address1: | 3200 BLUE RIDGE RD STE 100 | ||||||||
| Address2: | |||||||||
| City: | RALEIGH | ||||||||
| State: | NC | ||||||||
| PostalCode: | 276128087 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9197811437 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 08/05/2022 | ||||||||
| LastUpdateDate: | 08/05/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 08/05/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363A00000X | Y | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant |
No ID Information.