Provider Demographics
NPI:1558328278
Name:THAI, QUOC-ANH (MD)
Entity Type:Individual
Prefix:DR
First Name:QUOC-ANH
Middle Name:
Last Name:THAI
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 64286
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21264-4286
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4927 AUBURN AVE STE 200
Practice Address - Street 2:
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20814-2641
Practice Address - Country:US
Practice Address - Phone:301-896-6069
Practice Address - Fax:301-718-3459
Is Sole Proprietor?:No
Enumeration Date:2006-04-27
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC200600270207T00000X
MDD60572207T00000X
TXN9655207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8CV353OtherBCBSTX
TX8CV353OtherBCBSTX
MDKR38L360Medicare PIN
TXTXB137776Medicare PIN