Individual
DR. DONTESE JAMINE NICHOLSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
6820 HOSPITAL DR, STE 302, BALTIMORE, MD 21237-4352
(410) 682-2823
(410) 682-9551
Mailing address
11350 MCCORMICK RD, EXECUTIVE PLAZA I, SUITE 501, HUNT VALLEY, MD 21031-1002
(410) 682-2823
(410) 682-9551
Taxonomy
Speciality
Code
Description
License number
State
207LP2900X
Pain Medicine (Anesthesiology) Physician
D0074632
MD
208VP0014X
Interventional Pain Medicine Physician
Primary
D0074632
MD
Other
Enumeration date
11/03/2008
Last updated
06/18/2021
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