Healthcare Provider Details

I. General information

NPI: 1407821408
Provider Name (Legal Business Name): VINH Q. MAI D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/22/2006
Last Update Date: 02/24/2025
Certification Date: 02/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8901 WISCONSIN AVE
BETHESDA MD
20889-5600
US

IV. Provider business mailing address

8901 WISCONSIN AVE
BETHESDA MD
20889-5600
US

V. Phone/Fax

Practice location:
  • Phone: 301-295-5165
  • Fax: 301-295-5170
Mailing address:
  • Phone: 301-295-5165
  • Fax: 301-295-5170

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number0102201478
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: