Provider Demographics
NPI:1982976122
Name:NIEMAN, LYNNETTE (MD)
Entity Type:Individual
Prefix:DR
First Name:LYNNETTE
Middle Name:
Last Name:NIEMAN
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 1:10 CENTER DR, MSC 1109
Mailing Address - Street 2:BLDG 10/CRC, 1 EAST, RM 1-3140
Mailing Address - City:BETHESDA
Mailing Address - State:MD
Mailing Address - Zip Code:20892-1109
Mailing Address - Country:US
Mailing Address - Phone:301-496-8935
Mailing Address - Fax:301-402-0884
Practice Address - Street 1:9309 OLD GEORGETOWN RD
Practice Address - Street 2:
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20814-1620
Practice Address - Country:US
Practice Address - Phone:301-493-2400
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-02-03
Last Update Date:2012-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY142923207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism