Individual
NICHOLAS JAMES FITZPATRICK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
1 GENESYS PKWY, GRAND BLANC, MI 48439-8065
(303) 887-9022
Mailing address
201 FULTON ST W APT 811, GRAND BLANC, MI 48439-2600
(303) 887-9022
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
5151013650
MI
2086S0129X
Vascular Surgery Physician
5101028205
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5315207242
STATE OF MICHIGAN, DEPARTMENT OF LICENSING AND REGULATORY AFFAIRS, BOARD OF PHAM
MI
Enumeration date
06/06/2019
Last updated
07/15/2025
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