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General NPI Number Information
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NPI Number | 1396795605
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Entity Type | Organization
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Legal Business Name | NGOC-HA THI NGUYEN MD PC
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Dates
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Enumeration Date | 05/10/2006
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Last Update Date | 03/11/2024
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Provider Practice Location Address
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Address Line | 7202C POPLAR ST
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City | ANNANDALE
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State | VA
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Zip | 22003
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Country | US
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Telephone | 703-642-3220
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Fax | 703-778-9863
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Provider Business Mailing Address
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Address Line | PO BOX 1645
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City | ANNANDAUE
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State | VA
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Zip | 22003
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Country | US
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Telephone | 703-642-3220
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Fax | 703-778-9863
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. NGOC HA THI NGUYEN
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Credential | MD
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Telephone | 703-642-3220
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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 | 0101053981
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License Number State | VA
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