Provider Demographics
NPI:1801162466
Name:NGUYEN-BINDER, JESSICA VI (MD)
Entity type:Individual
Prefix:
First Name:JESSICA
Middle Name:VI
Last Name:NGUYEN-BINDER
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 1:4660 WILKENS AVE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21229-4848
Mailing Address - Country:US
Mailing Address - Phone:410-247-0782
Mailing Address - Fax:
Practice Address - Street 1:4660 WILKENS AVE
Practice Address - Street 2:SUITE 100
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21229-4848
Practice Address - Country:US
Practice Address - Phone:410-247-0782
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-03-28
Last Update Date:2016-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0079593207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine