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Individual

GRACE NIKLAS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
210 WHITING ST, SUITE 4, HINGHAM, MA 02043-3724
(781) 749-6131
(781) 749-6167
Mailing address
210 WHITING ST, SUITE 4, HINGHAM, MA 02043-3724
(781) 749-6131
(781) 749-6167

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
50515
MA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
3000010
MA
Enumeration date
07/12/2006
Last updated
12/05/2007
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