Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 0101232253 | VA |
N | 111NI0900X | Internist | 0101232253 | VA |
Y | 207R00000X | Internist | D0062443 | MD |
Y | 111NI0900X | Internist | D0062443 | MD |
N | 207SG0201X | Clinical Genetics (M.D.) | 0101232253 | VA |
N | 207SG0201X | Clinical Genetics (M.D.) | D0062443 | MD |
N | 208000000X | Pediatrician | 0101232253 | VA |
N | 208000000X | Pediatrician | D0062443 | MD |
NPI | 1497925176 |
---|---|
Provider Name | Michelle Claudine Nino |
First Address | Chevy Chase, MD 20815-4404 |
Second Address | Chevy Chase, MD 20815-4404 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/03/2008 |
Last Update Date | 25/10/2010 |