Provider Demographics
NPI:1114950920
Name:NOUR, SEEMA E (MD)
Entity Type:Individual
Prefix:
First Name:SEEMA
Middle Name:E
Last Name:NOUR
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2901 TELESTAR CT.
Mailing Address - Street 2:#300
Mailing Address - City:FALLS CHURCH
Mailing Address - State:VA
Mailing Address - Zip Code:22042-1263
Mailing Address - Country:US
Mailing Address - Phone:703-591-1688
Mailing Address - Fax:703-591-1445
Practice Address - Street 1:2901 TELESTAR CT
Practice Address - Street 2:#200
Practice Address - City:FALLS CHURCH
Practice Address - State:VA
Practice Address - Zip Code:22042-1260
Practice Address - Country:US
Practice Address - Phone:703-573-3494
Practice Address - Fax:703-573-5353
Is Sole Proprietor?:No
Enumeration Date:2006-07-08
Last Update Date:2015-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101252393207RC0000X, 207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1114950920Medicaid
MD34710801Medicaid
DCP011129547OtherRAILROAD MEDICARE
VAVV6920AMedicare PIN
VA1114950920Medicaid