Organization
MICHAEL R NICHOLSON MD PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICHAEL R NICHOLSON MD (OWNER)
(248) 456-8001
Entity
Organization
Contact information
Practice address
5220 HIGHLAND RD, SUITE 230, WATERFORD, MI 48327-1975
(248) 456-8001
Mailing address
PO BOX 1481, CLARKSTON, MI 48347-1481
(248) 456-8001
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
—
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4973416
—
MI
Enumeration date
01/25/2007
Last updated
02/04/2015
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