Provider Demographics
NPI:1750372587
Name:TRUONG, ANNE N (MD)
Entity type:Individual
Prefix:
First Name:ANNE
Middle Name:N
Last Name:TRUONG
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 1:10340 SPOTSYLVANIA AVE.
Mailing Address - Street 2:SUITE 101
Mailing Address - City:FREDERICKSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22408
Mailing Address - Country:US
Mailing Address - Phone:540-374-3164
Mailing Address - Fax:540-899-1342
Practice Address - Street 1:10340 SPOTSYLVANIA AVE.
Practice Address - Street 2:SUITE 101
Practice Address - City:FREDERICKSBURG
Practice Address - State:VA
Practice Address - Zip Code:22408
Practice Address - Country:US
Practice Address - Phone:540-374-3164
Practice Address - Fax:540-899-1342
Is Sole Proprietor?:No
Enumeration Date:2005-11-01
Last Update Date:2007-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101228930208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA6802770Medicaid
G08200Medicare UPIN