Healthcare Provider Details

I. General information

NPI: 1346219482
Provider Name (Legal Business Name): ANH DAI KIM NGUYEN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/14/2006
Last Update Date: 11/01/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6 PIDGEON HILL DR SUITE 205
STERLING VA
20165-6146
US

IV. Provider business mailing address

PO BOX 17334
BALTIMORE MD
21297-1334
US

V. Phone/Fax

Practice location:
  • Phone: 703-444-7234
  • Fax: 703-444-7201
Mailing address:
  • Phone: 703-443-6717
  • Fax: 703-443-8643

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207KA0200X
TaxonomyAllergy Physician
License Number0101234418
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: