Provider Demographics
NPI:1083079222
Name:TRAN, TIN DOAN (PHARMD)
Entity Type:Individual
Prefix:
First Name:TIN
Middle Name:DOAN
Last Name:TRAN
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18 ONEILL DR
Mailing Address - Street 2:APARTMENT 4
Mailing Address - City:GAITHERSBURG
Mailing Address - State:MD
Mailing Address - Zip Code:20877-1565
Mailing Address - Country:US
Mailing Address - Phone:240-644-8970
Mailing Address - Fax:
Practice Address - Street 1:18 ONEILL DR
Practice Address - Street 2:APARTMENT 4
Practice Address - City:GAITHERSBURG
Practice Address - State:MD
Practice Address - Zip Code:20877-1565
Practice Address - Country:US
Practice Address - Phone:240-644-8970
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-12-15
Last Update Date:2015-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD23621183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist