MEDICARE: TONG THANH MA M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208600000X	Surgery Physician	D0055086	MD

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1518954411
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TONG THANH MA M.D.

Provider Business Mailing Address
First Line	:	5801 ALLENTOWN RD
Second Line	:	SUITE 502
City	:	CAMP SPRINGS
State	:	MD
Zip	:	20746-4563
Country	:	US
Telephone Number	:	240-427-1630
Fax Number	:	240-492-2070

Provider Business Practice Location Address
First Line	:	5801 ALLENTOWN RD
Second Line	:	SUITE 502
City	:	CAMP SPRINGS
State	:	MD
Zip	:	20746-4563
Country	:	US
Telephone Number	:	240-427-1630
Fax Number	:	240-492-2070

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/05/2005
Last Update Date	:	01/17/2014

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