Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Q00000X | Family Doctor | 0101240541 | VA |
Y | 207QA0505X | Family Doctor - Adult Medicine | D0067576 | MD |
NPI | 1245334408 |
---|---|
Provider Name | Vivien Ngah-Tse To |
First Address | Columbia, MD 21045-2368 |
Second Address | Columbia, MD 21045-2368 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/09/2006 |
Last Update Date | 29/09/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
417070900 | (05) | MD |
D0067576 | MEDICAL LICENSE (01) |