Individual
MICHELLE R NICHOLS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
213C E MARION ST, PILOT MTN, NC 27041-8535
(336) 368-1070
(336) 368-1071
Mailing address
PO BOX 791, 213 C EAST MARION ST, PILOT MTN, NC 27041-0791
(336) 368-1070
(336) 368-1071
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
9801727
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
89129N0
—
NC
Enumeration date
08/03/2005
Last updated
07/08/2007
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