Individual
DR. MICHAEL L NICHOLAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2506 WILLOWBROOK PKWY, SUITE 300, INDIANAPOLIS, IN 46205-1564
(317) 574-1254
(317) 674-0059
Mailing address
9615 E 148TH ST, SUITE 1, NOBLESVILLE, IN 46060-4360
(317) 587-0500
(317) 674-0059
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
01036176A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100353310
—
IN
Enumeration date
07/13/2005
Last updated
06/02/2011
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