Individual
DUONG THAI LY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1006 TAVERN RD, MARTINSBURG, WV 25401-2864
(304) 267-5141
(304) 267-5140
Mailing address
PO BOX 62556, BALTIMORE, MD 21264-2556
(302) 709-4528
(302) 733-0854
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
0101246849
VA
207L00000X
Anesthesiology Physician
Primary
24121
WV
207L00000X
Anesthesiology Physician
D69151
MD
Other
Enumeration date
07/28/2006
Last updated
05/05/2011
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