Individual
NICHOLAS THEODORE SEVERYN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
705 RILEY HOSPITAL DR, INDIANAPOLIS, IN 46202-5109
(317) 274-4779
(317) 948-9806
Mailing address
PO BOX 719094, CHICAGO, IL 60677-9318
(317) 777-6435
(317) 777-6644
Taxonomy
Speciality
Code
Description
License number
State
2080N0001X
Neonatal-Perinatal Medicine Physician
Primary
02005617A
IN
2080N0001X
Neonatal-Perinatal Medicine Physician
TP779
KY
Other
Enumeration date
04/24/2016
Last updated
04/14/2026
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