Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208D00000X | General Practice Physician | 0101030960 | VA |
NPI | 1033364773 |
---|---|
Provider Name | Thuan Dinh Ngo |
First Address | Arlington, VA 22203 |
Second Address | Arlington, VA 22203 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 21/11/2008 |
Last Update Date | 21/11/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
B94204 | (02) |