Provider Demographics
NPI:1528069796
Name:NGUYEN, HONG T (MD)
Entity type:Individual
Prefix:
First Name:HONG
Middle Name:T
Last Name:NGUYEN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12006 KILARNEY DR
Mailing Address - Street 2:
Mailing Address - City:FREDERICKSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22407-7207
Mailing Address - Country:US
Mailing Address - Phone:540-786-9771
Mailing Address - Fax:540-548-8803
Practice Address - Street 1:12006 KILARNEY DR
Practice Address - Street 2:
Practice Address - City:FREDERICKSBURG
Practice Address - State:VA
Practice Address - Zip Code:22407-7207
Practice Address - Country:US
Practice Address - Phone:540-786-9771
Practice Address - Fax:540-548-8803
Is Sole Proprietor?:No
Enumeration Date:2005-08-10
Last Update Date:2010-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101050169207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA010000661Medicaid
VA010000661Medicaid
VA00V012A79Medicare ID - Type UnspecifiedMEDICARE