Individual
ANGELA M. NICHOLAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
212 N MAIN ST STE 203, NORTH WALES, PA 19454-3129
(215) 699-1501
(215) 699-1505
Mailing address
PO BOX 789967, PHILADELPHIA, PA 19178-9967
(484) 622-7395
(484) 622-7399
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD056659L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001480231
—
PA
01
—
1553630
UNITEDHEALTHCARE
PA
01
—
447950
HIGHMARK BLUE SHIELD
PA
01
—
5476555
AETNA
PA
01
—
F96308
HEALTHAMERICA
PA
Enumeration date
03/10/2006
Last updated
11/15/2018
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