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Organization

NIX DIRECT ACCESS PEDIATRICS PC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
KIJANA N NIX MD (CEO)
(301) 823-5999
Entity
Organization

Contact information

Practice address
10274 LAKE ARBOR WAY STE 201, MITCHELLVILLE, MD 20721-3146
(301) 823-5999
(301) 823-5990
Mailing address
10274 LAKE ARBOR WAY STE 201, MITCHELLVILLE, MD 20721-3146
(301) 823-5999
(301) 823-5990

Taxonomy

Speciality
Code
Description
License number
State
2080A0000X
Pediatric Adolescent Medicine Physician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1043368756
NPI
MD
05
319072200
MD
Enumeration date
05/27/2022
Last updated
08/02/2024
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