Provider Demographics
NPI:1083856413
Name:NGO, DUC ANH (MD)
Entity Type:Individual
Prefix:
First Name:DUC
Middle Name:ANH
Last Name:NGO
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 1:1100 9TH AVE
Mailing Address - Street 2:MS M4-PA
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98101-2756
Mailing Address - Country:US
Mailing Address - Phone:206-583-6079
Mailing Address - Fax:206-583-2307
Practice Address - Street 1:1100 9TH AVE
Practice Address - Street 2:MS M4-PA
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98101-2756
Practice Address - Country:US
Practice Address - Phone:206-583-6079
Practice Address - Fax:206-583-2307
Is Sole Proprietor?:No
Enumeration Date:2009-03-31
Last Update Date:2013-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
WAMD60275066207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA1083856413Medicaid
WAP01123468OtherRAILROAD MEDICARE
WAP01123468OtherRAILROAD MEDICARE