Healthcare Provider Details

I. General information

NPI: 1760776041
Provider Name (Legal Business Name): MARIA XIMENA TRAA KIELY MD MPH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MARIA XIMENA TRAA MD

II. Dates (important events)

Enumeration Date: 06/05/2011
Last Update Date: 12/17/2025
Certification Date: 12/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4102 WILSON BLVD
ARLINGTON VA
22203-1802
US

IV. Provider business mailing address

6201 GREENLEIGH AVE
MIDDLE RIVER MD
21220-2004
US

V. Phone/Fax

Practice location:
  • Phone: 703-462-1777
  • Fax:
Mailing address:
  • Phone: 410-933-0000
  • Fax: 503-963-2825

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208C00000X
TaxonomyColon & Rectal Surgery Physician
License NumberMD188947
License Number StateOR
# 2
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number0101284860
License Number StateVA
# 3
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberD0103035
License Number StateMD
# 4
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number248886
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: