Provider Demographics
NPI:1194831065
Name:NGUYEN, UY QUOC (MD)
Entity Type:Individual
Prefix:MR
First Name:UY
Middle Name:QUOC
Last Name:NGUYEN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:5565 COLUMBIA PIKE
Mailing Address - Street 2:STE 115
Mailing Address - City:ARLINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:22204-3114
Mailing Address - Country:US
Mailing Address - Phone:703-671-8979
Mailing Address - Fax:703-671-8969
Practice Address - Street 1:5565 COLUMBIA PIKE APT 115
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:VA
Practice Address - Zip Code:22204-3114
Practice Address - Country:US
Practice Address - Phone:703-671-8979
Practice Address - Fax:703-671-8969
Is Sole Proprietor?:No
Enumeration Date:2006-08-22
Last Update Date:2011-08-17
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VA0101055806207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA5828317Medicaid
VA5828317Medicaid
G62160Medicare UPIN