MEDICARE: BAO G VO 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	207R00000X	Internal Medicine Physician	D0074313	MD
2	207R00000X	Internal Medicine Physician	0101255065	VA

General Provider Information

NPI Number	:	1275777963
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BAO G VO MD

Provider Business Mailing Address
First Line	:	1005 N GLEBE RD STE 160
Second Line	:
City	:	ARLINGTON
State	:	VA
Zip	:	22201-5758
Country	:	US
Telephone Number	:	571-492-3045
Fax Number	:	703-780-0461

Provider Business Practice Location Address
First Line	:	1005 N GLEBE RD STE 160
Second Line	:
City	:	ARLINGTON
State	:	VA
Zip	:	22201-5758
Country	:	US
Telephone Number	:	571-492-3045
Fax Number	:	703-780-0461

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

Provider Enumeration Date	:	04/24/2009
Last Update Date	:	11/27/2023

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Directions to “ BAO G VO MD” Practice Location

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