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Individual

HOWARD R. NIEMAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
P.A.

Contact information

Practice address
3300 GALLOWS RD, FALLS CHURCH, VA 22042-3300
(703) 776-4001
(703) 776-7113
Mailing address
PO BOX 37174, BALTIMORE, MD 21297-3174
(571) 423-5698
(571) 423-5698

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0110840194
VA
363A00000X
Physician Assistant
PA10004700
WA
363AS0400X
Surgical Physician Assistant
0110840194
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0190947
L & I WORKERS COMP
WA
01
0669NI
REGENCE BLUESHIELD RIDER
WA
05
1215997713
VA
05
8411043
WA
01
P00185676
RAILROAD MEDICARE
WA
Enumeration date
03/27/2006
Last updated
04/01/2022
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