Provider Demographics
NPI:1033195664
Name:NGUYEN, DUONG X (MD)
Entity type:Individual
Prefix:DR
First Name:DUONG
Middle Name:X
Last Name:NGUYEN
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 1:213 S JEFFERSON ST STE 1006
Mailing Address - Street 2:
Mailing Address - City:ROANOKE
Mailing Address - State:VA
Mailing Address - Zip Code:24011-1713
Mailing Address - Country:US
Mailing Address - Phone:540-224-5353
Mailing Address - Fax:
Practice Address - Street 1:2900 LAMB CIR STE 302
Practice Address - Street 2:
Practice Address - City:CHRISTIANSBURG
Practice Address - State:VA
Practice Address - Zip Code:24073-6341
Practice Address - Country:US
Practice Address - Phone:540-731-2000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-12-15
Last Update Date:2025-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101050090207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAC10061OtherMEDICARE GROUP PIN
VAP00381571OtherRAILROAD MEDICARE
VA1033195664Medicaid
VA456157OtherSOUTHERN HEALTH
VA247331OtherANTHEM
VA00X297C04Medicare PIN
VA060000947Medicare PIN
VAF79454Medicare UPIN
VAC10061OtherMEDICARE GROUP PIN