Provider Demographics
NPI:1083789382
Name:BUI, NGOC KIM (RPH)
Entity Type:Individual
Prefix:
First Name:NGOC
Middle Name:KIM
Last Name:BUI
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20821 SETH CT
Mailing Address - Street 2:
Mailing Address - City:CALLAWAY
Mailing Address - State:MD
Mailing Address - Zip Code:20620-2321
Mailing Address - Country:US
Mailing Address - Phone:301-994-9858
Mailing Address - Fax:
Practice Address - Street 1:46075 SIGNATURE LN
Practice Address - Street 2:
Practice Address - City:LEXINGTON PARK
Practice Address - State:MD
Practice Address - Zip Code:20653-1342
Practice Address - Country:US
Practice Address - Phone:301-862-4830
Practice Address - Fax:301-862-4820
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD13287183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist