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Individual
DR. MICHAEL D. NICKELL
Active
Individual
DR. MICHAEL D. NICKELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
R9A40
MO
208M00000X
Hospitalist Physician
Primary
R9A40
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
20896
BNDD
MO
Enumeration date
09/21/2005
Last updated
04/17/2009
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