Healthcare Provider Details

I. General information

NPI: 1780785451
Provider Name (Legal Business Name): EUGENE J LOUIENG, MD, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/26/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8650 SUDLEY ROAD SUITE 303
MANASSAS VA
20110
US

IV. Provider business mailing address

8650 SUDLEY ROAD SUITE 303
MANASSAS VA
20110
US

V. Phone/Fax

Practice location:
  • Phone: 703-361-3551
  • Fax: 703-365-7702
Mailing address:
  • Phone: 703-361-3551
  • Fax: 703-365-7702

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number0101240017
License Number StateVA

VIII. Authorized Official

Name: DR. EUGENE J LOUIE-NG
Title or Position: PRESIDENT
Credential: M.D.
Phone: 703-361-3551