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Individual

MAI HOANG NGUYEN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
410 MAPLE AVE W STE 3, VIENNA, VA 22180-4224
(703) 281-3626
(703) 281-3615
Mailing address
410 MAPLE AVE W STE 3, VIENNA, VA 22180-4224
(703) 281-3626
(703) 281-3615

Taxonomy

Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
0101244058
VA
207Q00000X
Family Medicine Physician
A94851
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
948510
CA
Enumeration date
11/02/2006
Last updated
12/04/2018
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