Individual
DR. ANNE M NICKODEM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
8229 BOONE BLVD STE 365, VIENNA, VA 22182-2623
(703) 560-8711
(703) 552-2015
Mailing address
8229 BOONE BLVD STE 365, VIENNA, VA 22182-2623
(703) 560-8711
(703) 552-2015
Taxonomy
Speciality
Code
Description
License number
State
208200000X
Plastic Surgery Physician
Primary
0101047333
WV
Other
Enumeration date
03/31/2008
Last updated
07/30/2025
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