Individual
DHIMITRI ARIAN NIKOLLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
311 W 24TH ST, 4TH FLOOR, ERIE, PA 16502-2665
(814) 452-5109
Mailing address
311 W 24TH ST, 4TH FLOOR, ERIE, PA 16502-2665
(814) 452-5109
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
OS019010
PA
207P00000X
Emergency Medicine Physician
OT016316
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
OS019010
PENNSYLVANIA MEDICAL LICENSE
PA
Enumeration date
04/21/2015
Last updated
03/12/2019
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