Individual
DR. NICOLE COLLEEN PELHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
9300 DEWITT LOOP, FORT BELVOIR, VA 22060-5285
(571) 231-7334
Mailing address
9460 HANCHIN PL, LORTON, VA 22079-3139
(703) 855-5397
Taxonomy
Speciality
Code
Description
License number
State
171000000X
Military Health Care Provider
—
—
207Q00000X
Family Medicine Physician
Primary
101241510
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
160261702
—
TX
Enumeration date
08/22/2006
Last updated
08/19/2024
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