Individual
NICHOLAS PAUL NUNNALLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
1375 N MAIN ST, LAPEER, MI 48446-1350
(810) 667-5590
Mailing address
401 S BALLENGER HWY, FLINT, MI 48532-3638
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
5101016846
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1043436462
—
MI
Enumeration date
04/17/2007
Last updated
10/13/2016
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