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General NPI Number Information
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NPI Number | 1679796635
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Entity Type | Individual
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Provider Name | UYEN PHUONG VIETJE M.D.
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Gender | Female
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Dates
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Enumeration Date | 04/10/2007
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Last Update Date | 02/24/2015
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Provider Practice Location Address
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Address Line | 77 NEALY AVE LANGLEY AFB PATHOLOGY DEPT
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City | HAMPTON
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State | VA
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Zip | 23665-2040
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Country | US
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Telephone | 757-764-9622
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Fax |
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Provider Business Mailing Address
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Address Line | 107 NORTON RD
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City | WORCESTER
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State | VT
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Zip | 05682-9791
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Country | US
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Telephone | 802-578-7702
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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 | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State | VT
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Taxonomy #2
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Taxonomy Code | 207ZP0102X
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Taxonomy Name | Anatomic Pathology & Clinical Pathology Physician
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License Number | MD438637
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License Number State | PA
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