Provider Demographics
NPI:1205810967
Name:NGUYEN, DZUY TAN (MD)
Entity type:Individual
Prefix:DR
First Name:DZUY
Middle Name:TAN
Last Name:NGUYEN
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 1:249 DEER RUN DR
Mailing Address - Street 2:
Mailing Address - City:WALKERSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21793-8192
Mailing Address - Country:US
Mailing Address - Phone:301-845-4195
Mailing Address - Fax:
Practice Address - Street 1:6825 16TH ST NW
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20306-0003
Practice Address - Country:US
Practice Address - Phone:301-319-0000
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-12-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY227359207ZF0201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZF0201XAllopathic & Osteopathic PhysiciansPathologyForensic Pathology