Provider Demographics
NPI:1932849338
Name:DUONG-QUANG, MAC-CHAU (PHARMACIST)
Entity Type:Individual
Prefix:MR
First Name:MAC-CHAU
Middle Name:
Last Name:DUONG-QUANG
Suffix:
Gender:M
Credentials:PHARMACIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:45131 COLUMBIA PL
Mailing Address - Street 2:
Mailing Address - City:STERLING
Mailing Address - State:VA
Mailing Address - Zip Code:20166-2501
Mailing Address - Country:US
Mailing Address - Phone:703-421-2445
Mailing Address - Fax:703-421-2498
Practice Address - Street 1:45131 COLUMBIA PL
Practice Address - Street 2:
Practice Address - City:STERLING
Practice Address - State:VA
Practice Address - Zip Code:20166-2501
Practice Address - Country:US
Practice Address - Phone:703-421-2445
Practice Address - Fax:703-421-2498
Is Sole Proprietor?:No
Enumeration Date:2022-04-01
Last Update Date:2022-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY06256501183500000X
VA0202012587183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist