Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Q00000X | Family Doctor | 0101266405 | VA |
NPI | 1003264730 |
---|---|
Provider Name | Anh Truong |
First Address | Baltimore, MD 21297-3189 |
Second Address | Vienna, VA 22180-4653 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 03/06/2016 |
Last Update Date | 19/10/2020 |