Healthcare Provider Details

I. General information

NPI: 1952178550
Provider Name (Legal Business Name): PEDIATRICS OF SEVEN CORNERS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/05/2023
Last Update Date: 12/05/2023
Certification Date: 12/05/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6404 SEVEN CORNERS PL STE K
FALLS CHURCH VA
22044-2034
US

IV. Provider business mailing address

6404 SEVEN CORNERS PL STE K
FALLS CHURCH VA
22044-2034
US

V. Phone/Fax

Practice location:
  • Phone: 703-536-8864
  • Fax: 703-536-4290
Mailing address:
  • Phone: 703-536-8864
  • Fax: 703-536-4290

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. LAMSON DANG NGUYEN
Title or Position: PHYSICIAN
Credential: DO
Phone: 703-536-8864