Healthcare Provider Details

I. General information

NPI: 1245970789
Provider Name (Legal Business Name): MARILYN MACNGUYEN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/31/2022
Last Update Date: 07/29/2026
Certification Date: 07/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7601 OSLER DR
TOWSON MD
21204-7700
US

IV. Provider business mailing address

7601 OSLER DR
TOWSON MD
21204-7700
US

V. Phone/Fax

Practice location:
  • Phone: 410-337-1000
  • Fax:
Mailing address:
  • Phone: 410-337-1000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberD0107417
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: