Provider Demographics
NPI:1861588584
Name:NGUYEN, CAM-VAN P (PHARMD)
Entity type:Individual
Prefix:
First Name:CAM-VAN
Middle Name:P
Last Name:NGUYEN
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10410 SWIFT STREAM PL
Mailing Address - Street 2:APT #302
Mailing Address - City:COLUMBIA
Mailing Address - State:MD
Mailing Address - Zip Code:21044-4590
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:10410 SWIFT STREAM PL
Practice Address - Street 2:APT #302
Practice Address - City:COLUMBIA
Practice Address - State:MD
Practice Address - Zip Code:21044-4590
Practice Address - Country:US
Practice Address - Phone:410-605-7651
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-04
Last Update Date:2008-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA58709183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist