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Individual
DR. BROCK JAMES NICELER
Active
Individual
DR. BROCK JAMES NICELER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
2010-01146
NC
207QS0010X
Sports Medicine (Family Medicine) Physician
2010-01146
NC
207QS0010X
Sports Medicine (Family Medicine) Physician
27244
WV
207QS0010X
Sports Medicine (Family Medicine) Physician
Primary
S0344
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
159H0
BCBSNC
NC
05
—
5915411
—
NC
Enumeration date
01/20/2008
Last updated
02/11/2019
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