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General NPI Number Information
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NPI Number | 1205853983
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Entity Type | Organization
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Legal Business Name | EVERGREEN OB/GYN P.C.
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Dates
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Enumeration Date | 07/17/2006
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Last Update Date | 12/14/2007
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Provider Practice Location Address
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Address Line | 4328 EVERGREEN LN SUITE E
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City | ANNANDALE
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State | VA
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Zip | 22003-3257
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Country | US
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Telephone | 703-941-5070
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Fax | 703-941-8955
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Provider Business Mailing Address
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Address Line | 4330 EVERGREEN LN STE F
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City | ANNANDALE
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State | VA
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Zip | 22003-3258
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Country | US
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Telephone | 703-941-5070
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Fax | 703-941-8955
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Authorized Official
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Title or Position | PHYSICIAN
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Name | DR. THUY N HO
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Credential | M.D.
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Telephone | 703-941-5070
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 0101032935
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License Number State | VA
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