Organization
BARCROFT DERMATOLOGY, LLC
Active
Organization
BARCROFT DERMATOLOGY, LLC
Active
Other names
Mai H. Nguyen, MD
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MAI HOANG NGUYEN MD (OWNER)
(703) 892-3636
Entity
Organization
Contact information
Practice address
939 S WAKEFIELD ST, ARLINGTON, VA 22204-3084
(703) 892-3636
(703) 892-3626
Mailing address
727 MCKINLEY ST NE, VIENNA, VA 22180-3405
(703) 281-3626
(703) 281-3615
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
0101244058
VA
261QH0100X
Health Service Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00A948510
MEDICAID
CA
05
—
00A948510
—
CA
01
—
0101244058
VA LICENSE
VA
01
—
A94851
CA LICENSE
CA
Enumeration date
01/10/2018
Last updated
12/04/2018
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