Provider Demographics
NPI:1811179443
Name:HO, PHUONG DINH (MD)
Entity type:Individual
Prefix:
First Name:PHUONG
Middle Name:DINH
Last Name:HO
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Gender:M
Credentials:MD
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Mailing Address - Street 1:7115 GUILFORD DR
Mailing Address - Street 2:STE 202
Mailing Address - City:FREDERICK
Mailing Address - State:MD
Mailing Address - Zip Code:21704-5199
Mailing Address - Country:US
Mailing Address - Phone:301-663-5922
Mailing Address - Fax:301-663-8292
Practice Address - Street 1:7115 GUILFORD DR
Practice Address - Street 2:STE 202
Practice Address - City:FREDERICK
Practice Address - State:MD
Practice Address - Zip Code:21704-5199
Practice Address - Country:US
Practice Address - Phone:301-663-5922
Practice Address - Fax:301-663-8292
Is Sole Proprietor?:No
Enumeration Date:2007-12-05
Last Update Date:2013-09-11
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Provider Licenses
StateLicense IDTaxonomies
DCMD036940207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD302218YETCMedicare PIN