Individual
NICHOLAS J. ECONOMIDES
Active
Individual
NICHOLAS J. ECONOMIDES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
2086X0206X
Surgical Oncology Physician
Primary
1274
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000239823
ANTHEM BCBS
—
01
—
001714145
MOUNTAIN STATE BCBS
—
01
—
240007884
RR MEDICARE
—
Enumeration date
05/17/2006
Last updated
08/18/2015
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