Provider Demographics
NPI:1851548184
Name:THAI, TUONG VINH (MD)
Entity Type:Individual
Prefix:
First Name:TUONG
Middle Name:VINH
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 3284
Mailing Address - Street 2:10660 PAGE AVE
Mailing Address - City:FAIRFAX
Mailing Address - State:VA
Mailing Address - Zip Code:22038-3284
Mailing Address - Country:US
Mailing Address - Phone:517-990-4148
Mailing Address - Fax:
Practice Address - Street 1:2759 MARTIN LUTHER KING JR AVE SE
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20032-2646
Practice Address - Country:US
Practice Address - Phone:517-990-4148
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-19
Last Update Date:2016-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCDC154232084P0800X
MI43010606162084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry