Provider Demographics
NPI:1750516340
Name:SELIM, NANCY (DO)
Entity type:Individual
Prefix:DR
First Name:NANCY
Middle Name:
Last Name:SELIM
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8991 COTSWOLD DR
Mailing Address - Street 2:
Mailing Address - City:BURKE
Mailing Address - State:VA
Mailing Address - Zip Code:22015-1657
Mailing Address - Country:US
Mailing Address - Phone:703-440-0107
Mailing Address - Fax:703-440-8246
Practice Address - Street 1:8991 COTSWOLD DR
Practice Address - Street 2:
Practice Address - City:BURKE
Practice Address - State:VA
Practice Address - Zip Code:22015-1657
Practice Address - Country:US
Practice Address - Phone:703-440-0107
Practice Address - Fax:703-440-8246
Is Sole Proprietor?:No
Enumeration Date:2009-05-26
Last Update Date:2012-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA2OA10424207Q00000X
VA0112202707207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine