Provider Demographics
NPI:1053374181
Name:DAM, HUNG QUANG (MD)
Entity type:Individual
Prefix:DR
First Name:HUNG
Middle Name:QUANG
Last Name:DAM
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:NUCLEAR MEDICINE
Mailing Address - Street 2:4755 OGLETOWN-STANTON RD
Mailing Address - City:NEWARK
Mailing Address - State:DE
Mailing Address - Zip Code:19718
Mailing Address - Country:US
Mailing Address - Phone:302-733-1530
Mailing Address - Fax:302-733-1540
Practice Address - Street 1:NUCLEAR MEDICINE
Practice Address - Street 2:4755 OGLETOWN-STANTON RD
Practice Address - City:NEWARK
Practice Address - State:DE
Practice Address - Zip Code:19718
Practice Address - Country:US
Practice Address - Phone:302-733-1530
Practice Address - Fax:302-733-1540
Is Sole Proprietor?:No
Enumeration Date:2006-04-10
Last Update Date:2019-11-16
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
DEC1-0006905207U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207U00000XAllopathic & Osteopathic PhysiciansNuclear Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
DEH86227Medicare UPIN