Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207V00000X | Obstetrician & Gynecologist | D0040627 | MD |
NPI | 1003807363 |
---|---|
Provider Name | Thu Ngoc Tran |
First Address | Fulton, MD 20759-2694 |
Second Address | Rockville, MD 20850-3320 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/11/2005 |
Last Update Date | 30/03/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
317221000 | (05) | MD |
G00121 | (02) | MD |