Provider Demographics
NPI:1831434208
Name:VU, MAI TRAM THI (PHARM,D)
Entity type:Individual
Prefix:
First Name:MAI TRAM
Middle Name:THI
Last Name:VU
Suffix:
Gender:F
Credentials:PHARM,D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12800 LEDO CREEK TER
Mailing Address - Street 2:
Mailing Address - City:BELTSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20705-5106
Mailing Address - Country:US
Mailing Address - Phone:571-314-6227
Mailing Address - Fax:
Practice Address - Street 1:8901 WISCONSIN AVE
Practice Address - Street 2:
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20889-2203
Practice Address - Country:US
Practice Address - Phone:301-319-3434
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-12-11
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202211508183500000X
MD20204183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist