# CONSTANTINE T NICHOLAS

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1295790228
- **Gender:** Man
- **Credential:** MD

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207X00000X | Orthopaedic Surgery Physician | 4301032764 | MI | — |
| 207X00000X | Orthopaedic Surgery Physician | C33836 | CA | Yes |

## Other

- **Enumeration date:** 04/20/2006
- **Last updated:** 04/13/2013

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 102059860 | — | MI |