Provider Demographics
NPI:1457513848
Name:LE, UYENPHUONG HO (MD)
Entity Type:Individual
Prefix:DR
First Name:UYENPHUONG
Middle Name:HO
Last Name:LE
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:PO BOX 603725
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28260-3725
Mailing Address - Country:US
Mailing Address - Phone:828-575-2625
Mailing Address - Fax:828-350-2174
Practice Address - Street 1:3833 N FAIRFAX DRIVE
Practice Address - Street 2:SUITE 350
Practice Address - City:ARLINGTON
Practice Address - State:VA
Practice Address - Zip Code:22203-1774
Practice Address - Country:US
Practice Address - Phone:703-312-6712
Practice Address - Fax:703-312-6716
Is Sole Proprietor?:No
Enumeration Date:2008-06-27
Last Update Date:2023-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCMD038059207R00000X
MDD0069374207K00000X, 207R00000X
VA0101245790207R00000X, 207K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & Immunology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1457513848Medicaid
DCVVJ894F106OtherMEDICARE PTAN
VA174967ZRGMOtherMEDICARE PTAN