Provider Demographics
NPI:1811981475
Name:TRAN, NATHAN N (MD)
Entity type:Individual
Prefix:DR
First Name:NATHAN
Middle Name:N
Last Name:TRAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:PO BOX 37189
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21297-3189
Mailing Address - Country:US
Mailing Address - Phone:571-423-5699
Mailing Address - Fax:571-423-5698
Practice Address - Street 1:11800 SUNRISE VALLEY DR STE 700
Practice Address - Street 2:
Practice Address - City:RESTON
Practice Address - State:VA
Practice Address - Zip Code:20191-5315
Practice Address - Country:US
Practice Address - Phone:703-834-1473
Practice Address - Fax:703-318-7463
Is Sole Proprietor?:No
Enumeration Date:2005-09-09
Last Update Date:2023-06-27
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
VA0101235718207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA010191912Medicaid
VA010191912Medicaid
VA013899F32Medicare ID - Type Unspecified