Individual
NICHOLAS WILLIAM BERRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
50 OLD VILLAGE RD, COLUMBUS, OH 43228-1583
(614) 544-1976
(614) 544-1981
Mailing address
250 N SHADELAND AVE, INDIANAPOLIS, IN 46219-4959
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
02006356A
IN
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300049893
—
IN
Enumeration date
03/12/2018
Last updated
05/14/2025
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