Healthcare Provider Details

I. General information

NPI: 1518443654
Provider Name (Legal Business Name): HANG NGUYEN OD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/12/2018
Last Update Date: 08/25/2026
Certification Date: 08/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2465 ROUTE 97 STE 11
GLENWOOD MD
21738-9749
US

IV. Provider business mailing address

2465 ROUTE 97 STE 11
GLENWOOD MD
21738-9749
US

V. Phone/Fax

Practice location:
  • Phone: 443-333-5258
  • Fax: 443-343-0856
Mailing address:
  • Phone: 443-333-5258
  • Fax: 443-343-0856

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License NumberTA2732
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: