Healthcare Provider Details

I. General information

NPI: 1164590519
Provider Name (Legal Business Name): HONG HANH T CHAU MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/02/2006
Last Update Date: 11/22/2021
Certification Date: 11/22/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19450 DEERFIELD AVE STE 300 LOUDOUN MEDICAL CENTER
LANSDOWNE VA
20176-6821
US

IV. Provider business mailing address

2101 EAST JEFFERSON STREET PPQA MEDICARE COMPLIANCE UNIT 6W ATTN THERESA BROOKS
ROCKVILLE MD
20852-4908
US

V. Phone/Fax

Practice location:
  • Phone: 703-726-2100
  • Fax: 703-726-4550
Mailing address:
  • Phone: 301-816-6660
  • Fax: 301-816-6308

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number0101055894
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: