Healthcare Provider Details

I. General information

NPI: 1346331170
Provider Name (Legal Business Name): BARBARA M. NIES M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/27/2006
Last Update Date: 12/07/2022
Certification Date: 12/07/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8081 INNOVATION PARK DR STE 301
FAIRFAX VA
22031-4867
US

IV. Provider business mailing address

11101 PRINCE EDWARD CT
OAKTON VA
22124-1034
US

V. Phone/Fax

Practice location:
  • Phone: 703-698-5350
  • Fax: 703-204-1074
Mailing address:
  • Phone: 703-262-0117
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License Number042260
License Number StateVA
# 2
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number0101042260
License Number StateVA
# 3
Primary TaxonomyY
Taxonomy Code207VM0101X
TaxonomyMaternal & Fetal Medicine Physician
License Number0101042260
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: