Individual
CONSTANTINE T NICHOLAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2500 ALHAMBRA AVE, MARTINEZ, CA 94553-3156
(925) 370-5200
Mailing address
2500 ALHAMBRA AVE, MARTINEZ, CA 94553-3156
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
4301032764
MI
207X00000X
Orthopaedic Surgery Physician
Primary
C33836
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
102059860
—
MI
Enumeration date
04/20/2006
Last updated
04/13/2013
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