MEDICARE: THE VIRGINIA INSTITUTE PLLC

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	207YS0123X	Facial Plastic Surgery Physician	0101246352	VA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	0101246352	OTHER	MD	MEDICAL LICENSE

General Provider Information

NPI Number	:	1770835480
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THE VIRGINIA INSTITUTE PLLC

Provider Business Mailing Address
First Line	:	25055 RIDING PLZ
Second Line	:	SUITE 140
City	:	CHANTILLY
State	:	VA
Zip	:	20152-5917
Country	:	US
Telephone Number	:	703-327-8200
Fax Number	:	703-327-7800

Provider Business Practice Location Address
First Line	:	25055 RIDING PLZ
Second Line	:	SUITE 140
City	:	CHANTILLY
State	:	VA
Zip	:	20152-5917
Country	:	US
Telephone Number	:	703-327-8200
Fax Number	:	703-327-7800

Authorized Official
Title or Position	:	OWNER/PHYSICIAN
Name	:	DR. TRANG T. VO-NGUYEN
Credential	:	MD
Telephone Number	:	703-327-8200

Provider Enumeration Date	:	10/04/2012
Last Update Date	:	10/04/2012

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Directions to “THE VIRGINIA INSTITUTE PLLC ” Practice Location

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