Provider Demographics
NPI:1871503219
Name:HOANG, TRUONG XUAN (MD)
Entity Type:Individual
Prefix:DR
First Name:TRUONG
Middle Name:XUAN
Last Name:HOANG
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 1:636 UNIVERSITY BLVD E
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20901-3768
Mailing Address - Country:US
Mailing Address - Phone:301-439-6499
Mailing Address - Fax:301-439-3619
Practice Address - Street 1:636 UNIVERSITY BLVD E
Practice Address - Street 2:
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20901-3768
Practice Address - Country:US
Practice Address - Phone:301-439-6499
Practice Address - Fax:301-439-3619
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0029616208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDE36721Medicare UPIN
049628Medicare ID - Type Unspecified