| Doctor Name: | DR. KATHY DIEP NGOC TIEU |
| NPI Number: | 1811973951 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | M.D. |
| License Number: | 0101235150 |
| Business Practice Address: | 3700 Joseph Siewick Dr 404 Fairfax, VA - 220331744 |
| Business Phone Number: | 7036208900 |
| Business Fax Number: | 7036202288 |
| Mailing Address: | 12544 Pinecrest Rd, HERNDON |
| State: | VA |
| Postal Code: | 201712530 |
| Phone Number: | |
| Fax Number: | |
| NPI Enumeration Date: | 12/20/2005 |
| NPI Last Update Date: | 02/15/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | 0101235150 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | VA |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |