Provider Demographics
NPI:1316966427
Name:TON, MARTIN VU THAT (MD)
Entity type:Individual
Prefix:
First Name:MARTIN
Middle Name:VU THAT
Last Name:TON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1080 FIRST COLONIAL RD STE 201
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23454-2439
Mailing Address - Country:US
Mailing Address - Phone:757-395-6450
Mailing Address - Fax:
Practice Address - Street 1:1080 FIRST COLONIAL RD STE 201
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23454-2439
Practice Address - Country:US
Practice Address - Phone:757-395-6450
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-19
Last Update Date:2025-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101049320208VP0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA5709172Medicaid
VA5710120Medicaid
50000864Medicare ID - Type Unspecified
VA5709172Medicaid
50001234Medicare ID - Type Unspecified