Individual
DR. RICHARD A. NICKLAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1830 TOWN CENTER DR, SUITE #206, RESTON, VA 20190-3236
(703) 437-5151
(703) 280-4650
Mailing address
8318 ARLINGTON BLVD, SUITE #308, FAIRFAX, VA 22031-5218
(703) 573-4440
(703) 280-4650
Taxonomy
Speciality
Code
Description
License number
State
207KA0200X
Allergy Physician
Primary
0101025325
VA
207KA0200X
Allergy Physician
MD3203
DC
Other
Enumeration date
03/24/2006
Last updated
01/03/2012
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