Healthcare Provider Details

I. General information

NPI: 1992329197
Provider Name (Legal Business Name): AIDAN JOY BERRY-NGUYEN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: AIDAN JOY BERRY MD

II. Dates (important events)

Enumeration Date: 06/03/2020
Last Update Date: 09/10/2026
Certification Date: 09/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2301 ERWIN RD
DURHAM NC
27705-4699
US

IV. Provider business mailing address

PO BOX 780125
PHILADELPHIA PA
19178-0125
US

V. Phone/Fax

Practice location:
  • Phone: 919-681-4844
  • Fax:
Mailing address:
  • Phone: 804-922-4844
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number0101290039
License Number StateVA
# 2
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number0101290039
License Number StateVA
# 3
Primary TaxonomyY
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number2024-01695
License Number StateNC
# 4
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number0101290039
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: