MEDICARE: DR. QUOC-ANH THAI MD

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	207T00000X	Neurological Surgery Physician	200600270	NC
2	207T00000X	Neurological Surgery Physician	D60572	MD
3	207T00000X	Neurological Surgery Physician	N9655	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	8CV353	OTHER	TX	BCBSTX

General Provider Information

NPI Number	:	1558328278
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. QUOC-ANH THAI MD

Provider Business Mailing Address
First Line	:	PO BOX 64286
Second Line	:
City	:	BALTIMORE
State	:	MD
Zip	:	21264-4286
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4927 AUBURN AVE STE 200
Second Line	:
City	:	BETHESDA
State	:	MD
Zip	:	20814-2641
Country	:	US
Telephone Number	:	301-896-6069
Fax Number	:	301-718-3459

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

Provider Enumeration Date	:	04/27/2006
Last Update Date	:	03/17/2018

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Directions to “ DR. QUOC-ANH THAI MD” Practice Location

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