Provider Demographics
NPI:1225176605
Name:BEN NGUYEN, M.D., PC
Entity Type:Organization
Organization Name:BEN NGUYEN, M.D., PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:BEN
Authorized Official - Middle Name:
Authorized Official - Last Name:NGUYEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:703-876-4270
Mailing Address - Street 1:8501 ARLINGTON BLVD
Mailing Address - Street 2:SUITE 330
Mailing Address - City:FAIRFAX
Mailing Address - State:VA
Mailing Address - Zip Code:22031-4617
Mailing Address - Country:US
Mailing Address - Phone:703-876-4270
Mailing Address - Fax:703-876-4276
Practice Address - Street 1:8501 ARLINGTON BLVD
Practice Address - Street 2:SUITE 330
Practice Address - City:FAIRFAX
Practice Address - State:VA
Practice Address - Zip Code:22031-4617
Practice Address - Country:US
Practice Address - Phone:703-876-4270
Practice Address - Fax:703-876-4276
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-01
Last Update Date:2007-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101059150207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
DC5314-0001OtherCARE FIRST PROV #
WV6100006000Medicaid
MD663203300Medicaid
VA006105572Medicaid
VA226790OtherANTHEM PROVIDER #
VA490285Medicare ID - Type UnspecifiedMEDICARE PROVIDER NO.
VAG87141Medicare UPIN
MD663203300Medicaid