Maryam N/a Nicksolat

NPI #1215027545 in Mc Lean, Virginia

Provider Information

NPI Number: 1215027545
Entity Type: Individual
Name: Maryam N/a Nicksolat
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Physician Assistant
Enumeration Date: Oct 16, 2006
Last Updated: Apr 24, 2017

Practice Location

Address: 8370 GREENSBORO DR
City: Mc Lean
State: Virginia
ZIP Code: 22102-3515
Phone: (703) 200-7727

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physician Assistant	363A00000X	Primary

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