Individual
NICHOLAS BASIL LOUDAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1575 BEAM AVE, MAPLEWOOD, MN 55109-1126
(651) 232-7970
Mailing address
1575 BEAM AVE, MAPLEWOOD, MN 55109-1126
(651) 232-7970
Taxonomy
Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
1250224
IA
2085R0001X
Radiation Oncology Physician
Primary
78623
MN
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/06/2015
Last updated
01/03/2025
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