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Individual

DR. DAVID W MCNICHOLS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Taxonomy

Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
0361036581
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0361036581
IL
01
068148
HEALTHALLIANCE
IL
01
2500053
BCBS
IL
01
340018705
RAILROAD MEDICARE IDENT.#
IL
01
451985
HEALTHLINK
IL
01
CC9824
RAILROAD MEDICARE
IL
Enumeration date
04/18/2006
Last updated
03/03/2008
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