Provider Demographics
NPI:1164476818
Name:LOUIE-NG, EUGENE J (MD)
Entity Type:Individual
Prefix:DR
First Name:EUGENE
Middle Name:J
Last Name:LOUIE-NG
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:PO BOX 748613
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30374-8613
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:7915 LAKE MANASSAS DRIVE
Practice Address - Street 2:SUITE 205
Practice Address - City:GAINESVILLE
Practice Address - State:VA
Practice Address - Zip Code:20155
Practice Address - Country:US
Practice Address - Phone:866-775-3551
Practice Address - Fax:703-365-7702
Is Sole Proprietor?:No
Enumeration Date:2006-05-19
Last Update Date:2023-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101230347207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
212177OtherANTHEM
VA6205232Medicaid
1187852002OtherCIGNA
VA292836Medicaid
21881OtherUNICARE
2636038OtherAETNA
388653OtherMAMSI
505708OtherNCPPO
0701734OtherUNITED HEALTHCARE
VA292836Medicaid