MEDICARE: DR. LYN NGUYEN DEA D.O.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	H0058097	MD

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
5	80184145	OTHER	MD	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	0073009	OTHER	MD	CIGNA PIN NUMBER
2	7744382	OTHER	MD	AETNA FEE FOR SERVICE
3	2981630	OTHER	MD	AETNA CAPITATED
4	8110689	OTHER	MD	MAMSI PRIMARY CARE
6	P15500	OTHER	MD	CAREFIRST MPOS
7	2110689	OTHER	MD	MAMSI SPECIALIST
8	7605-0050	OTHER	MD	CAREFIRST BLUECHOICE
9	615698-01	OTHER	MD	CAREFIRST RENDERING
10	014378	OTHER	MD	JHHC PROVIDER NUMBER
11	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1063413599
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LYN NGUYEN DEA D.O.

Provider Business Mailing Address
First Line	:	7580 BUCKINGHAM BLVD STE 220
Second Line	:
City	:	HANOVER
State	:	MD
Zip	:	21076-3210
Country	:	US
Telephone Number	:	410-729-5100
Fax Number	:

Provider Business Practice Location Address
First Line	:	129 LUBRANO DR
Second Line	:	SUITE 100
City	:	ANNAPOLIS
State	:	MD
Zip	:	21401-7566
Country	:	US
Telephone Number	:	410-266-5852
Fax Number	:	410-266-5095

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/09/2005
Last Update Date	:	02/28/2024

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Directions to “ DR. LYN NGUYEN DEA D.O.” Practice Location

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