Individual
DR. JONATHAN MICHAEL NICHOLS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
22 BRAMHALL ST, PORTLAND, ME 04102-3134
(207) 662-0111
Mailing address
22 BRAMHALL ST, PORTLAND, ME 04102-3134
(207) 662-0111
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
DO3353
ME
208M00000X
Hospitalist Physician
DO3353
ME
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/31/2017
Last updated
07/27/2022
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