Individual
RICARDO NIMO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
270 E MAIN ST, CENTREVILLE, MS 39631-4200
(601) 645-5361
Mailing address
178 HIGHWAY 24 E, CENTREVILLE, MS 39631-4171
(601) 890-0520
(601) 645-5088
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
16415
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00121244
—
MS
05
—
1560201
—
LA
Enumeration date
05/19/2006
Last updated
11/14/2023
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