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General NPI Number Information
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NPI Number | 1417291204
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Entity Type | Individual
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Provider Name | DAO ANH MAI PA
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Gender | Female
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Dates
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Enumeration Date | 11/16/2012
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Last Update Date | 11/16/2012
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Provider Practice Location Address
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Address Line | 2115 WISCONSIN AVE NW SUITE 130
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City | WASHINGTON
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State | DC
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Zip | 20007-2265
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Country | US
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Telephone | 202-784-2687
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Fax | 202-784-0791
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Provider Business Mailing Address
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Address Line | 3135 SINGLETON CIR
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City | FAIRFAX
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State | VA
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Zip | 22030-2122
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Country | US
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Telephone | 703-273-7186
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Fax | 202-784-0791
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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 | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | PA238
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License Number State | DC
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Taxonomy #2
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | C0001628
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License Number State | MD
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Taxonomy #3
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | 0110840690
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License Number State | VA
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