Provider Demographics
NPI:1740310960
Name:NICHOLS, ARLENE PEARL (MD)
Entity type:Individual
Prefix:DR
First Name:ARLENE
Middle Name:PEARL
Last Name:NICHOLS
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 1:808 STURBRIDGE LN
Mailing Address - Street 2:
Mailing Address - City:BOWIE
Mailing Address - State:MD
Mailing Address - Zip Code:20716-3721
Mailing Address - Country:US
Mailing Address - Phone:301-908-5154
Mailing Address - Fax:
Practice Address - Street 1:9015 WOODYARD RD
Practice Address - Street 2:SUITE 111
Practice Address - City:CLINTON
Practice Address - State:MD
Practice Address - Zip Code:20735-4209
Practice Address - Country:US
Practice Address - Phone:301-599-0900
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-06
Last Update Date:2012-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0034384208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics