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Individual

DR. NIKKI WADDELL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
5901 KINGSTOWNE VILLAGE PKWY, SUITE 300, ALEXANDRIA, VA 22315-5880
(571) 384-6304
(571) 384-6309
Mailing address
PO BOX 17334, BALTIMORE, MD 21297-1334
(703) 443-6717
(703) 443-8643

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
0101239628
VA

Other

Enumeration date
07/26/2006
Last updated
07/24/2012
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