Provider Demographics
NPI:1578820841
Name:NGUYEN, KHOI A (MD)
Entity Type:Individual
Prefix:
First Name:KHOI
Middle Name:A
Last Name:NGUYEN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:KHOI
Other - Middle Name:AN THO
Other - Last Name:NGUYEN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:2800 GODWIN BLVD FL 1
Mailing Address - Street 2:
Mailing Address - City:SUFFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23434-8038
Mailing Address - Country:US
Mailing Address - Phone:757-934-4821
Mailing Address - Fax:757-934-4276
Practice Address - Street 1:2800 GODWIN BLVD FL 1
Practice Address - Street 2:
Practice Address - City:SUFFOLK
Practice Address - State:VA
Practice Address - Zip Code:23434-8038
Practice Address - Country:US
Practice Address - Phone:757-934-4821
Practice Address - Fax:757-934-4276
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-11
Last Update Date:2022-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101258252208M00000X, 207R00000X
NY63226390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program