Individual
MR. MICHAEL CHI DONG VUONG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
882 GARRISONVILLE RD, STAFFORD, VA 22554-3907
(540) 318-6464
Mailing address
3907 FAIRFAX PKWY, ALEXANDRIA, VA 22312-1147
(703) 798-4109
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0110007759
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1386229060
—
VA
05
—
30017745910001
—
VA
05
—
30017745910002
—
VA
Enumeration date
03/14/2021
Last updated
03/06/2024
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