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Individual
JOHN C NINOS
Active
Individual
JOHN C NINOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
G88658
CA
207Q00000X
Family Medicine Physician
MD025659E
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0018716640001
MEDICAID
PA
01
—
1772699
HIGHMARK BS
PA
01
—
50055533
CAPITOL BC
PA
Enumeration date
03/17/2006
Last updated
02/29/2016
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