| Mai H. Nguyen, Md | |
|
939 S Wakefield St Arlington VA 22204-3084 | |
| (703) 892-3636 | |
| (703) 892-3626 |
| Full Name | Mai H. Nguyen, Md |
|---|---|
| Speciality | Clinic/Center |
| Location | 939 S Wakefield St, Arlington, Virginia |
| Authorized Official Name and Position | Mai Hoang Nguyen (OWNER) |
| Authorized Official Contact | 7038923636 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mai H. Nguyen, Md 727 Mckinley St Ne Vienna VA 22180-3405 Ph: (703) 281-3626 | Mai H. Nguyen, Md 939 S Wakefield St Arlington VA 22204-3084 Ph: (703) 892-3636 |
| NPI Number | 1215444377 |
|---|---|
| Provider Enumeration Date | 01/10/2018 |
| Last Update Date | 12/04/2018 |
| Medicare PECOS PAC ID | 3577997048 |
|---|---|
| Medicare Enrollment ID | O20191217001363 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1215444377 | NPI | - | NPPES |
| 0101244058 | Other | VA | VA LICENSE |
| 00A948510 | Other | CA | MEDICAID |
| A94851 | Other | CA | CA LICENSE |
| 00A948510 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | 0101244058 (Virginia) | Primary |
| 261QH0100X | Clinic/center - Health Service | (* (Not Available)) | Secondary |
| Provider Name | Mai Hoang Nguyen |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1275612319 PECOS PAC ID: 3173525441 Enrollment ID: I20091216000527 |
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