Provider Demographics
NPI:1760208177
Name:HO, VIETHO CONG
Entity type:Individual
Prefix:
First Name:VIETHO
Middle Name:CONG
Last Name:HO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:120 SEURAT LN
Mailing Address - Street 2:
Mailing Address - City:MARTINSBURG
Mailing Address - State:WV
Mailing Address - Zip Code:25403-7682
Mailing Address - Country:US
Mailing Address - Phone:301-272-4700
Mailing Address - Fax:
Practice Address - Street 1:120 SEURAT LN
Practice Address - Street 2:
Practice Address - City:MARTINSBURG
Practice Address - State:WV
Practice Address - Zip Code:25403-7682
Practice Address - Country:US
Practice Address - Phone:301-272-4700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-12-02
Last Update Date:2024-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant