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General NPI Number Information
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NPI Number | 1003835091
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Entity Type | Individual
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Provider Name | NITA SUMIDA M.D.
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Gender | Female
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Dates
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Enumeration Date | 07/19/2006
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Last Update Date | 03/07/2023
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Provider Practice Location Address
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Address Line | 1760 OLD MEADOW ROAD SUITE 500
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City | MCLEAN
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State | VA
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Zip | 22102-2210
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Country | US
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Telephone | 703-810-5217
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Fax | 703-288-7892
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Provider Business Mailing Address
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Address Line | 1115 BOULDERS PARKWAY SUITE 200
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City | NORTH CHESTERFIELD
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State | VA
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Zip | 23225-1223
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Country | US
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Telephone | 804-915-4607
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Fax | 804-968-1803
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 0101235316
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License Number State | VA
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