Individual
DR. NATHAN W MICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
22 BRAMHALL ST, PORTLAND, ME 04102-3134
(207) 662-7010
(207) 662-7025
Mailing address
22 BRAMHALL ST, PORTLAND, ME 04102-3134
(207) 662-7010
(207) 662-7025
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
MD16764
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2013801
—
ME
Enumeration date
09/21/2006
Last updated
02/06/2013
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