Provider Demographics
NPI:1043537731
Name:NGUYEN, BRIAN BAO (MD)
Entity Type:Individual
Prefix:DR
First Name:BRIAN
Middle Name:BAO
Last Name:NGUYEN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:MR
Other - First Name:BAO
Other - Middle Name:HOAI
Other - Last Name:PHAM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:110 IRVING STREET, NW
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:20010
Mailing Address - Country:US
Mailing Address - Phone:202-877-0720
Mailing Address - Fax:
Practice Address - Street 1:110 IRVING STREET, NW
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:VA
Practice Address - Zip Code:20010
Practice Address - Country:US
Practice Address - Phone:202-877-0720
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-04-21
Last Update Date:2021-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCMD041289207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine