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General NPI Number Information
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NPI Number | 1003981309
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Entity Type | Individual
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Provider Name | ANH BAO NGUYEN PHARMD
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Gender | Male
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Dates
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Enumeration Date | 11/21/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 25 HIGH ST
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City | WALDORF
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State | MD
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Zip | 20602-1842
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Country | US
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Telephone | 301-932-9826
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Fax |
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Provider Business Mailing Address
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Address Line | 20821 SETH CT
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City | CALLAWAY
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State | MD
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Zip | 20620-2321
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Country | US
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Telephone | 301-994-9858
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 16475
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License Number State | MD
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