Mai H. Nguyen, Md | |
939 S Wakefield St Arlington VA 22204-3084 | |
(703) 892-3636 | |
(703) 892-3626 |
Full Name | Mai H. Nguyen, Md |
---|---|
Speciality | Clinic/Center |
Location | 939 S Wakefield St, Arlington, Virginia |
Authorized Official Name and Position | Mai Hoang Nguyen (OWNER) |
Authorized Official Contact | 7038923636 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
Mai H. Nguyen, Md 727 Mckinley St Ne Vienna VA 22180-3405 Ph: (703) 281-3626 | Mai H. Nguyen, Md 939 S Wakefield St Arlington VA 22204-3084 Ph: (703) 892-3636 |
NPI Number | 1215444377 |
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Provider Enumeration Date | 01/10/2018 |
Last Update Date | 12/04/2018 |
Medicare PECOS PAC ID | 3577997048 |
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Medicare Enrollment ID | O20191217001363 |
Identifier | Type | State | Issuer |
---|---|---|---|
1215444377 | NPI | - | NPPES |
0101244058 | Other | VA | VA LICENSE |
00A948510 | Other | CA | MEDICAID |
A94851 | Other | CA | CA LICENSE |
00A948510 | Medicaid | CA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261Q00000X | Clinic/center | 0101244058 (Virginia) | Primary |
261QH0100X | Clinic/center - Health Service | (* (Not Available)) | Secondary |
Provider Name | Mai Hoang Nguyen |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1275612319 PECOS PAC ID: 3173525441 Enrollment ID: I20091216000527 |
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