Individual
GEORGE EZZAT NICOLAS
Active
Individual
GEORGE EZZAT NICOLAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CAA
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
577
FL
367H00000X
Anesthesiologist Assistant
75000154A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1103779329
ANTHEM PTAN
IN
Enumeration date
06/02/2020
Last updated
01/15/2025
Update your record
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