Provider Demographics
NPI:1861590390
Name:VU, TRUNG Q (MD)
Entity type:Individual
Prefix:
First Name:TRUNG
Middle Name:Q
Last Name:VU
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:322 E ANTIETAM ST
Mailing Address - Street 2:SUITE 106
Mailing Address - City:HAGERSTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:21740-5794
Mailing Address - Country:US
Mailing Address - Phone:301-739-6144
Mailing Address - Fax:301-739-6163
Practice Address - Street 1:322 E ANTIETAM ST
Practice Address - Street 2:SUITE 106
Practice Address - City:HAGERSTOWN
Practice Address - State:MD
Practice Address - Zip Code:21740-5794
Practice Address - Country:US
Practice Address - Phone:301-739-6144
Practice Address - Fax:301-739-6163
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2014-10-30
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MDD591962085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD387704300Medicaid
MDH547E211Medicare PIN
MD387704300Medicaid
300133235Medicare PIN
MDKN77E212Medicare PIN
300133234Medicare PIN