Healthcare Provider Details

I. General information

NPI: 1740269372
Provider Name (Legal Business Name): NGOC D TRAN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/12/2006
Last Update Date: 07/13/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

510 BUTLER AVE
MARTINSBURG WV
25401-9990
US

IV. Provider business mailing address

510 BUTLER AVE
MARTINSBURG WV
25401-9990
US

V. Phone/Fax

Practice location:
  • Phone: 304-263-0811
  • Fax:
Mailing address:
  • Phone: 304-263-0811
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2083X0100X
TaxonomyOccupational Medicine Physician
License NumberD0025971
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: