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Individual

STEVE MCNICHOLS

Active
Sole proprietor

Provider details

NPI number
Gender
Man

Contact information

Practice address
121 W CENTURY AVE, BISMARCK, ND 58503-1402
(701) 530-8500
(701) 530-8506
Mailing address
121 W CENTURY AVE, BISMARCK, ND 58503-1402
(701) 530-8500
(701) 530-8506

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
1217
ND

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
26160
BCBS
ND
05
50966
ND
Enumeration date
01/11/2006
Last updated
07/08/2007
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