IndividualActive
Nicol Awadalla Bacon, MD
NPI 1104062454 · Developmental - Behavioral Pediatrics Physician · Washington, DC
Provider details
- NPI number
- 1104062454
- Entity type
- Individual
- Primary specialty
- Developmental - Behavioral Pediatrics PhysicianAllopathic & Osteopathic Physicians
- Credential
- MD
- Sex
- Female
- Sole proprietor
- No
- License
- MD046588 (DC)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Practice location
111 Michigan Ave Nw
Washington, DC 20010-2916
Phone: (202) 476-5000
Approximate (ZIP-level) locationGet directions
Mailing address
Po Box 37215
Baltimore, MD 21297-3215
Registry dates
- Enumerated
- 2008-12-16
- Last updated
- 2018-10-18
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.