Individual
DR. CLAY A. NICHOLS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
600 MOYE BLVD, ECU PHYSICIANS PATHOLOGY, GREENVILLE, NC 27834-4300
(252) 744-2803
(252) 744-3616
Mailing address
PO BOX 751069, ECU PHYSICIANS, CHARLOTTE, NC 28275-1069
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
13038
SC
207ZF0201X
Forensic Pathology Physician
Primary
2011-00202
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
010678285
TAX-ID
SC
05
—
1396715157
—
NC
01
—
185CZ
BCBS NC
NC
05
—
GP3481
—
SC
Enumeration date
01/25/2006
Last updated
06/27/2014
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