Provider Demographics
NPI:1033195664
Name:NGUYEN, DUONG X (MD)
Entity Type:Individual
Prefix:DR
First Name:DUONG
Middle Name:X
Last Name:NGUYEN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:650 PETER JEFFERSON PKWY
Mailing Address - Street 2:STE 100
Mailing Address - City:CHARLOTTESVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22911-8844
Mailing Address - Country:US
Mailing Address - Phone:434-293-4072
Mailing Address - Fax:434-293-4265
Practice Address - Street 1:650 PETER JEFFERSON PKWY
Practice Address - Street 2:STE 100
Practice Address - City:CHARLOTTESVILLE
Practice Address - State:VA
Practice Address - Zip Code:22911-8844
Practice Address - Country:US
Practice Address - Phone:434-293-4072
Practice Address - Fax:434-293-4265
Is Sole Proprietor?:No
Enumeration Date:2005-12-15
Last Update Date:2018-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101050090207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA247331OtherANTHEM
VA456157OtherSOUTHERN HEALTH
VAP00381571OtherRAILROAD MEDICARE
VAC10061OtherMEDICARE GROUP PIN
VA1033195664Medicaid
VA00X297C04Medicare PIN
VA060000947Medicare PIN
VAF79454Medicare UPIN
VAC10061OtherMEDICARE GROUP PIN