Individual
MAURICE EUGENE NIDA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
295 WHARTON LN, NORTON, VA 24273-1541
(276) 679-0321
(276) 679-6498
Mailing address
999 EXECUTIVE PARK BLVD, SUITE 201, KINGSPORT, TN 37660-4632
(423) 224-3250
(423) 224-3258
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
0102049965
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
006084877
—
VA
Enumeration date
03/07/2006
Last updated
09/07/2012
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