Individual
DR. JOHN HERBERT NILES JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
7500 GREENWAY CENTER DR, SUITE 620, GREENBELT, MD 20770-3502
(301) 474-5400
(301) 474-0800
Mailing address
7500 GREENWAY CENTER DRIVE, SUITE 620, GREENBELT, MD 20770
(301) 320-0315
(301) 474-0800
Taxonomy
Speciality
Code
Description
License number
State
207VG0400X
Gynecology Physician
Primary
D0009397
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
05429
AMERIGROUP
MD
Enumeration date
09/06/2006
Last updated
07/08/2007
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