Provider Demographics
NPI:1972594737
Name:NABI, ANISSA A (MD)
Entity Type:Individual
Prefix:MISS
First Name:ANISSA
Middle Name:A
Last Name:NABI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:430 M SWST N105
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20024-2644
Mailing Address - Country:US
Mailing Address - Phone:202-368-4903
Mailing Address - Fax:888-257-5541
Practice Address - Street 1:1276N WAYNE ST SU
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:VA
Practice Address - Zip Code:22201-5848
Practice Address - Country:US
Practice Address - Phone:202-368-4903
Practice Address - Fax:888-257-5541
Is Sole Proprietor?:No
Enumeration Date:2005-11-02
Last Update Date:2017-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101237063207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA010176239Medicaid
VA1972594737Medicaid
VA1972594737Medicaid
P00251231Medicare PIN
VA010176239Medicaid