Individual
DR. NIV AD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
7901 MAPLE AVE, SUITE A, TAKOMA PARK, MD 20912-6331
(202) 524-4200
Mailing address
7901 MAPLE AVE STE A, SUITE 140, TAKOMA PARK, MD 20912-6331
(202) 524-4200
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
0101246383
VA
208600000X
Surgery Physician
0101246383
VA
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
0101246383
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
010111510
—
VA
Enumeration date
03/16/2006
Last updated
03/31/2017
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