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General NPI Number Information
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NPI Number | 1689201576
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Entity Type | Individual
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Provider Name | PAULA NGUYEN
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Gender | Female
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Dates
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Enumeration Date | 03/23/2020
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Last Update Date | 10/29/2024
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Provider Practice Location Address
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Address Line | 11110 MEDICAL CAMPUS RD STE 200
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City | HAGERSTOWN
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State | MD
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Zip | 21742-6797
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Country | US
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Telephone | 301-714-4400
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Fax |
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Provider Business Mailing Address
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Address Line | 11116 MEDICAL CAMPUS RD
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City | HAGERSTOWN
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State | MD
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Zip | 21742-6710
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Country | US
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Telephone |
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | A181928
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 036.164292
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License Number State | IL
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Taxonomy #3
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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 |
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Taxonomy #4
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | D0101917
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License Number State | MD
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