Provider Demographics
NPI:1730281205
Name:NITA SUMIDA, M.D. , P.L.L.C.
Entity Type:Organization
Organization Name:NITA SUMIDA, M.D. , P.L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:NITA
Authorized Official - Middle Name:
Authorized Official - Last Name:SUMIDA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:703-734-1069
Mailing Address - Street 1:6773 LITTLE FALLS RD
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:22213-1223
Mailing Address - Country:US
Mailing Address - Phone:703-734-1069
Mailing Address - Fax:703-288-7892
Practice Address - Street 1:8320 OLD COURTHOUSE RD
Practice Address - Street 2:SUITE 100
Practice Address - City:VIENNA
Practice Address - State:VA
Practice Address - Zip Code:22182-3831
Practice Address - Country:US
Practice Address - Phone:703-734-1069
Practice Address - Fax:703-288-7892
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-03
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
9371416OtherPHCS
633048OtherNCPPO
7233026OtherAETNA
169355OtherANTHEM
5456737OtherCIGNA
K169OtherCAREFIRST BCBS
I06720Medicare UPIN