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Individual

MYONG HO NAM

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
3300 GALLOWS RD, FALLS CHURCH, VA 22042-3307
(703) 776-6679
Mailing address
PO BOX 221322, CHANTILLY, VA 20153-1322
(703) 691-2516
(703) 691-3526

Taxonomy

Speciality
Code
Description
License number
State
207ZB0001X
Blood Banking & Transfusion Medicine Physician
Primary
0101040202
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1770584476
VA
Enumeration date
08/03/2005
Last updated
03/24/2009
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