Individual
DR. BAO NGOC NGUYEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
3025 HAMAKER CT STE 100, FAIRFAX, VA 22031-2229
(571) 405-6882
(571) 405-6883
Mailing address
3025 HAMAKER CT STE 100, FAIRFAX, VA 22031-2229
(571) 405-6882
(571) 405-6883
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
0102201555
VA
207Q00000X
Family Medicine Physician
H0082752
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
010219124
—
VA
Enumeration date
05/05/2006
Last updated
05/07/2024
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