Healthcare Provider Details

I. General information

NPI: 1932318490
Provider Name (Legal Business Name): THAO NGUYEN M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/22/2007
Last Update Date: 07/09/2024
Certification Date: 07/09/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9707 MEDICAL CENTER DR STE 220
ROCKVILLE MD
20850-6338
US

IV. Provider business mailing address

9707 MEDICAL CENTER DR STE 220
ROCKVILLE MD
20850-6338
US

V. Phone/Fax

Practice location:
  • Phone: 240-645-4683
  • Fax: 240-654-4696
Mailing address:
  • Phone: 240-654-4683
  • Fax: 240-654-4696

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207VF0040X
TaxonomyUrogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician
License NumberD0068587
License Number StateMD
# 2
Primary TaxonomyY
Taxonomy Code207VG0400X
TaxonomyGynecology Physician
License NumberD0068587
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: