Provider Demographics
NPI:1770992687
Name:NGUYEN, DAI I (PHARM D)
Entity type:Individual
Prefix:
First Name:DAI
Middle Name:
Last Name:NGUYEN
Suffix:I
Gender:M
Credentials:PHARM D
Other - Prefix:
Other - First Name:DAI
Other - Middle Name:
Other - Last Name:NGUYEN
Other - Suffix:I
Other - Last Name Type:Other Name
Other - Credentials:PHARM D
Mailing Address - Street 1:5417 JACKS CT
Mailing Address - Street 2:
Mailing Address - City:CATONSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21228-3705
Mailing Address - Country:US
Mailing Address - Phone:410-660-1266
Mailing Address - Fax:410-721-6325
Practice Address - Street 1:2003 DAVIDSONVILLE RD
Practice Address - Street 2:
Practice Address - City:CROFTON
Practice Address - State:MD
Practice Address - Zip Code:21114-1317
Practice Address - Country:US
Practice Address - Phone:410-721-3762
Practice Address - Fax:410-721-6325
Is Sole Proprietor?:No
Enumeration Date:2014-08-05
Last Update Date:2014-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD18143183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist