Individual
DR. COLTON MCNICHOLS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
601 N CAROLINE ST, JHOC 8152A, BALTIMORE, MD 21287-0006
(410) 502-7381
Mailing address
601 N CAROLINE ST, JHOC 8152A, BALTIMORE, MD 21287-0006
Taxonomy
Speciality
Code
Description
License number
State
208200000X
Plastic Surgery Physician
Primary
D80857
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
I20140708002042
MEDICARE PECOS
—
Enumeration date
03/25/2014
Last updated
01/15/2016
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