Provider Demographics
NPI:1548501489
Name:NGUYEN, TAM MINH (PHARM D)
Entity type:Individual
Prefix:DR
First Name:TAM
Middle Name:MINH
Last Name:NGUYEN
Suffix:
Gender:M
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 1:43480 YUKON DR STE 100
Mailing Address - Street 2:
Mailing Address - City:ASHBURN
Mailing Address - State:VA
Mailing Address - Zip Code:20147-6988
Mailing Address - Country:US
Mailing Address - Phone:571-252-6005
Mailing Address - Fax:571-252-6056
Practice Address - Street 1:43480 YUKON DR STE 100
Practice Address - Street 2:
Practice Address - City:ASHBURN
Practice Address - State:VA
Practice Address - Zip Code:20147-6988
Practice Address - Country:US
Practice Address - Phone:571-252-6005
Practice Address - Fax:571-252-6056
Is Sole Proprietor?:No
Enumeration Date:2013-03-01
Last Update Date:2013-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202204298183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist