Provider Demographics
NPI:1912208349
Name:HO, THUY NGUYEN (MD)
Entity Type:Individual
Prefix:MRS
First Name:THUY
Middle Name:NGUYEN
Last Name:HO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4328 E EVERGREEN LANE
Mailing Address - Street 2:
Mailing Address - City:ANNANDALE
Mailing Address - State:VA
Mailing Address - Zip Code:22003
Mailing Address - Country:US
Mailing Address - Phone:703-941-5070
Mailing Address - Fax:866-680-2259
Practice Address - Street 1:4328 E EVERGREEN LANE
Practice Address - Street 2:
Practice Address - City:ANNANDALE
Practice Address - State:VA
Practice Address - Zip Code:22003
Practice Address - Country:US
Practice Address - Phone:703-941-5070
Practice Address - Fax:866-680-2259
Is Sole Proprietor?:Yes
Enumeration Date:2010-11-17
Last Update Date:2010-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101032935207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA097655OtherANTHEM H.K.
VA1023113OtherAMERIGROUP
VA006233252Medicaid
VAB08719Medicare UPIN
VA509174Medicare PIN