Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RR0500X | Rheumatology | 010137786 | VA |
NPI | 1033298138 |
---|---|
Provider Name | Dr. Dorothy Mary Nicholson |
First Address | Alexandria, VA 22304-3418 |
Second Address | Alexandria, VA 22304-3418 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/11/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
5876257 | (05) | VA |
C88592 | (02) |