Provider Demographics
NPI:1962124198
Name:DUONG, CHRISTOPHER NHU
Entity type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:NHU
Last Name:DUONG
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6712 TURNAWAY LN
Mailing Address - Street 2:
Mailing Address - City:NORTH CHESTERFIELD
Mailing Address - State:VA
Mailing Address - Zip Code:23234-6021
Mailing Address - Country:US
Mailing Address - Phone:804-432-2166
Mailing Address - Fax:
Practice Address - Street 1:6400 CENTRALIA RD
Practice Address - Street 2:
Practice Address - City:CHESTERFIELD
Practice Address - State:VA
Practice Address - Zip Code:23832-6523
Practice Address - Country:US
Practice Address - Phone:804-796-9084
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-14
Last Update Date:2022-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202220712183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist