Provider Demographics
NPI:1417291204
Name:MAI, DAO ANH (PA)
Entity Type:Individual
Prefix:MS
First Name:DAO
Middle Name:ANH
Last Name:MAI
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3135 SINGLETON CIR
Mailing Address - Street 2:
Mailing Address - City:FAIRFAX
Mailing Address - State:VA
Mailing Address - Zip Code:22030-2122
Mailing Address - Country:US
Mailing Address - Phone:703-273-7186
Mailing Address - Fax:202-784-0791
Practice Address - Street 1:2115 WISCONSIN AVE NW
Practice Address - Street 2:SUITE 130
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20007-2265
Practice Address - Country:US
Practice Address - Phone:202-784-2687
Practice Address - Fax:202-784-0791
Is Sole Proprietor?:No
Enumeration Date:2012-11-16
Last Update Date:2012-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCPA238363AM0700X
MDC0001628363AM0700X
VA0110840690363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical