Provider Demographics
NPI:1912999566
Name:TRAN, GEORGE M (MD)
Entity Type:Individual
Prefix:
First Name:GEORGE
Middle Name:M
Last Name:TRAN
Suffix:
Gender:M
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:PO BOX 388
Mailing Address - Street 2:
Mailing Address - City:FISHERSVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22939-0388
Mailing Address - Country:US
Mailing Address - Phone:540-932-5162
Mailing Address - Fax:540-932-5875
Practice Address - Street 1:3881 CHURCHVILLE AVE
Practice Address - Street 2:
Practice Address - City:CHURCHVILLE
Practice Address - State:VA
Practice Address - Zip Code:24421-2525
Practice Address - Country:US
Practice Address - Phone:540-213-9260
Practice Address - Fax:540-213-9264
Is Sole Proprietor?:No
Enumeration Date:2005-08-19
Last Update Date:2023-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101045483207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA345647OtherANTHEM
VA48125OtherOPTIMA/SENTARA
VA5645379Medicaid
VA4459685OtherAETNA
VA6793515OtherCIGNA
VA1912999566Medicaid
VA61459602OtherBLACK LUNG/FECA
VAP00606604Medicare PIN
VA61459602OtherBLACK LUNG/FECA
VA5645379Medicaid
VA1912999566Medicaid