Provider Demographics
NPI:1851991665
Name:DUONG, KAVEN (PHARMD)
Entity Type:Individual
Prefix:
First Name:KAVEN
Middle Name:
Last Name:DUONG
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1825 QUIVERS KEEP
Mailing Address - Street 2:
Mailing Address - City:CHESAPEAKE
Mailing Address - State:VA
Mailing Address - Zip Code:23321-1439
Mailing Address - Country:US
Mailing Address - Phone:757-535-9922
Mailing Address - Fax:
Practice Address - Street 1:1825 QUIVERS KEEP
Practice Address - Street 2:
Practice Address - City:CHESAPEAKE
Practice Address - State:VA
Practice Address - Zip Code:23321-1439
Practice Address - Country:US
Practice Address - Phone:757-535-9922
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-10-30
Last Update Date:2020-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202218019183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA0202218019OtherPHARMACIST LISENCES