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Individual

NICHOLAI IAN KIEHL

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
11141 PARKVIEW PLAZA DR, SUITE 320, FORT WAYNE, IN 46845-1713
(260) 482-8681
(260) 266-9240
Mailing address
PO BOX 7527, DUBLIN, OH 43017-0727

Taxonomy

Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
01073785A
IN
208800000X
Urology Physician
35125593
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0119494
OH
05
201228420
IN
01
H411160
MEDICARE
OH
Enumeration date
03/24/2009
Last updated
10/02/2024
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