Individual
DR. CHARLES CHRISTOPHER NICHOLAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
3720 HOLLAND RD, STE 100, VIRGINIA BEACH, VA 23452-2859
(757) 498-0202
(757) 498-7936
Mailing address
3720 HOLLAND RD, STE 100, VIRGINIA BEACH, VA 23452-2859
(757) 498-0202
(757) 498-7936
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
0103300941
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
010210241
—
VA
01
—
10007473
OPTIMA HEALTH
—
01
—
196666
ANTHEM BLUE CROSS BLUE SH
VA
01
—
2138899
MDIPA
VA
01
—
5180770001
DMERC
VA
01
—
5180770002
DMERC
VA
01
—
P00324323
RR MEDICARE
VA
Enumeration date
04/20/2006
Last updated
03/21/2018
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