Provider Demographics
NPI:1295707560
Name:FISHER, NINA M (MD)
Entity type:Individual
Prefix:
First Name:NINA
Middle Name:M
Last Name:FISHER
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:1365 BEVERLY ROAD
Mailing Address - Street 2:SECOND FLOOR
Mailing Address - City:MCLEAN
Mailing Address - State:VA
Mailing Address - Zip Code:22101-3603
Mailing Address - Country:US
Mailing Address - Phone:703-790-5850
Mailing Address - Fax:703-790-1028
Practice Address - Street 1:1365 BEVERLY ROAD
Practice Address - Street 2:SECOND FLOOR
Practice Address - City:MCLEAN
Practice Address - State:VA
Practice Address - Zip Code:22101-3603
Practice Address - Country:US
Practice Address - Phone:703-790-5850
Practice Address - Fax:703-790-1028
Is Sole Proprietor?:No
Enumeration Date:2006-02-02
Last Update Date:2016-03-17
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
VA0101233673207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
H56162Medicare UPIN
011136D66Medicare ID - Type Unspecified