Individual
DR. JAWDAT A NIKOULA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
905 SPRUCE ST STE 201, IRWIN, PA 15642-3683
(724) 864-9595
(724) 864-9860
Mailing address
905 SPRUCE ST, SUITE 201, IRWIN, PA 15642-3683
(724) 864-9595
(724) 864-9860
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD032696E
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0009874960001
—
PA
01
—
CA3219
MEDICARE (RAILROAD)
—
Enumeration date
07/11/2005
Last updated
08/31/2023
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