Provider Demographics
NPI:1215045729
Name:TON-THAT, HAN (MD)
Entity Type:Individual
Prefix:MR
First Name:HAN
Middle Name:
Last Name:TON-THAT
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 1:6305 CASTLE PLACE
Mailing Address - Street 2:SUITE 1-A
Mailing Address - City:FALLS CHURCH
Mailing Address - State:VA
Mailing Address - Zip Code:22044
Mailing Address - Country:US
Mailing Address - Phone:703-534-9090
Mailing Address - Fax:703-534-9191
Practice Address - Street 1:6305 CASTLE PLACE
Practice Address - Street 2:SUITE 1-A
Practice Address - City:FALLS CHURCH
Practice Address - State:VA
Practice Address - Zip Code:22044
Practice Address - Country:US
Practice Address - Phone:703-534-9090
Practice Address - Fax:703-534-9191
Is Sole Proprietor?:No
Enumeration Date:2006-08-25
Last Update Date:2011-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101055233207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA005838380Medicaid
VA005838380Medicaid
G42970Medicare UPIN