MEDICARE: HONGHANH LISA NGUYEN M.D.

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	207V00000X	Obstetrics & Gynecology Physician	D0052961	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

General Provider Information

NPI Number	:	1467402370
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HONGHANH LISA NGUYEN M.D.

Provider Business Mailing Address
First Line	:	1509 LAKE NORWOOD WAY
Second Line	:
City	:	SANDY SPRING
State	:	MD
Zip	:	20860-3004
Country	:	US
Telephone Number	:	301-924-9025
Fax Number	:

Provider Business Practice Location Address
First Line	:	11016 NEW HAMPSHIRE AVE
Second Line	:
City	:	SILVER SPRING
State	:	MD
Zip	:	20904-2612
Country	:	US
Telephone Number	:	301-681-3300
Fax Number	:	301-681-4777

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

Provider Enumeration Date	:	05/11/2006
Last Update Date	:	06/07/2021

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