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General NPI Number Information
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NPI Number | 1932377058
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Entity Type | Individual
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Provider Name | JESSICA M. NGUYEN M.D.
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Gender | Female
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Dates
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Enumeration Date | 02/11/2008
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Last Update Date | 01/21/2021
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Provider Practice Location Address
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Address Line | 25 CROSSROADS DR STE 410
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City | OWINGS MILLS
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State | MD
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Zip | 21117-5439
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Country | US
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Telephone | 410-363-6144
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Fax | 410-363-7752
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Provider Business Mailing Address
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Address Line | 5430 CAMPBELL BLVD STE 103
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City | WHITE MARSH
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State | MD
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Zip | 21162-5503
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Country | US
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Telephone | 410-933-9404
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Fax | 410-933-9405
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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 | 207K00000X
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Taxonomy Name | Allergy & Immunology Physician
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License Number | D0073116
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License Number State | MD
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