Individual
DR. BRENT G NICHOLS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
801 BROADWAY N, FARGO, ND 58102-3641
(701) 234-2000
Mailing address
PO BOX 5074, SIOUX FALLS, SD 57117-5074
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
13649
ND
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/27/2010
Last updated
09/07/2021
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