Basic Information
| Provider Information | |||||||||
| NPI: | 1417427980 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | DO | ||||||||
| FirstName: | VEE | ||||||||
| MiddleName: | NGAN | ||||||||
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| Mailing Information | |||||||||
| Address1: | 105 FOREST RIDGE DR | ||||||||
| Address2: | |||||||||
| City: | STERLING | ||||||||
| State: | VA | ||||||||
| PostalCode: | 201642812 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 201 N WASHINGTON ST | ||||||||
| Address2: | |||||||||
| City: | FALLS CHURCH | ||||||||
| State: | VA | ||||||||
| PostalCode: | 220464518 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7032374000 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 11/27/2018 | ||||||||
| LastUpdateDate: | 11/27/2018 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 183500000X | 26195 | MD | N | Pharmacy Service Providers | Pharmacist | 183500000X | 0202217289 | VA | Y | Pharmacy Service Providers | Pharmacist |
No ID Information.