MEDICARE: VIVIEN NGAH-TSE TO MD

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	0101240541	VA
2	207QA0505X	Adult Medicine Physician	D0067576	MD

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	D0067576	OTHER		MEDICAL LICENSE

General Provider Information

NPI Number	:	1245334408
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	VIVIEN NGAH-TSE TO MD

Provider Business Mailing Address
First Line	:	5450 KNOLL NORTH DR STE 250
Second Line	:
City	:	COLUMBIA
State	:	MD
Zip	:	21045-2368
Country	:	US
Telephone Number	:	410-964-6200
Fax Number	:	410-964-6392

Provider Business Practice Location Address
First Line	:	5450 KNOLL NORTH DR STE 250
Second Line	:
City	:	COLUMBIA
State	:	MD
Zip	:	21045-2368
Country	:	US
Telephone Number	:	410-964-6200
Fax Number	:	410-964-6392

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

Provider Enumeration Date	:	09/11/2006
Last Update Date	:	09/29/2021

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Directions to “ VIVIEN NGAH-TSE TO MD” Practice Location

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