Healthcare Provider Details

I. General information

NPI: 1194067918
Provider Name (Legal Business Name): ZAO CHARLES VU MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/19/2013
Last Update Date: 07/30/2025
Certification Date: 07/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2211 LOMAS BLVD NE FL 2
ALBUQUERQUE NM
87106-2719
US

IV. Provider business mailing address

8805 MIRADOR PL
MC LEAN VA
22102-2209
US

V. Phone/Fax

Practice location:
  • Phone: 505-272-1113
  • Fax:
Mailing address:
  • Phone: 703-598-9268
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number4301102828
License Number StateMI
# 2
Primary TaxonomyN
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberMD044849
License Number StateDC
# 3
Primary TaxonomyN
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number0101261982
License Number StateVA
# 4
Primary TaxonomyN
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberMD-55486
License Number StateIA
# 5
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberMD2019-0080
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: