Individual
DR. JOHN NICEWICZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
6970 E CHAUNCEY LN STE 100, PHOENIX, AZ 85054-5158
(602) 788-7211
(602) 788-1890
Mailing address
3815 E BELL RD, 4400, PHOENIX, AZ 85032-2122
(602) 788-7211
(602) 788-1890
Taxonomy
Speciality
Code
Description
License number
State
207RP1001X
Pulmonary Disease Physician
25MA04019900
NJ
207RP1001X
Pulmonary Disease Physician
Primary
27020
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1333909
—
NJ
Enumeration date
06/08/2006
Last updated
02/14/2019
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