Vivan Mai, NP-C

Individual provider Active NPI Family Medicine Physician · Clifton, VA

NPI 1770097628 · NPPES record last updated Nov 29, 2017

Key facts

NPI
1770097628
Entity type
Individual (NPI type 1)
Primary specialty
Family Medicine Physician 207Q00000X
License
0024175494 (VA)
Practice address
7090 Balmoral Forest Rd
Clifton, VA 20124-1539
Phone
(703) 973-0291
NPI assigned
Nov 29, 2017
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
0024175494VAMDFamily Medicine Physician

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 0024175494 VA Yes

Addresses

Primary practice location

7090 Balmoral Forest Rd
Clifton, VA 20124-1539

Mailing address

7090 Balmoral Forest Rd
Clifton, VA 20124-1539

Other providers in Clifton, VA

All providers in Clifton, VA · Family Medicine Physician in Virginia

Sources for this page

Verify at the official NPI Registry.