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General NPI Number Information
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NPI Number | 1144704040
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Entity Type | Organization
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Legal Business Name | BAO DINH DO PC
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Dates
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Enumeration Date | 09/18/2018
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Last Update Date | 12/05/2018
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Provider Practice Location Address
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Address Line | 3301 WOODBURN RD STE 311
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City | ANNANDALE
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State | VA
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Zip | 22003-1229
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Country | US
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Telephone | 703-828-0048
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Fax | 703-574-8649
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Provider Business Mailing Address
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Address Line | 3301 WOODBURN RD STE 311
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City | ANNANDALE
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State | VA
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Zip | 22003-1229
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Country | US
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Telephone | 703-828-0048
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Fax |
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Authorized Official
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Title or Position | OWNER/PROVIDER
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Name | DR. BAO T DINH
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Credential | MD
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Telephone | 571-340-2989
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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