Individual
DR. KIMBERLY MARIE NICOL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
2799 W GRAND BLVD, DETROIT, MI 48202-2608
(313) 704-8419
Mailing address
15855 19 MILE RD, CLINTON TOWNSHIP, MI 48038-3504
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
5101019270
MI
Other
Enumeration date
03/30/2011
Last updated
10/09/2017
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