Provider Demographics
NPI:1326252776
Name:SHOWAN, NINA SUSAN (DC)
Entity Type:Individual
Prefix:DR
First Name:NINA
Middle Name:SUSAN
Last Name:SHOWAN
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:TWO HAMILL RD
Mailing Address - Street 2:SUITE 220
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21210
Mailing Address - Country:US
Mailing Address - Phone:410-435-0406
Mailing Address - Fax:410-435-0453
Practice Address - Street 1:TWO HAMILL RD
Practice Address - Street 2:SUITE 220
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21210
Practice Address - Country:US
Practice Address - Phone:410-435-0406
Practice Address - Fax:410-435-0453
Is Sole Proprietor?:No
Enumeration Date:2007-05-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD1216PT111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
M765Medicare ID - Type Unspecified
T59608Medicare UPIN