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Individual

DR. TIM J NICE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
34600 CHARDON RD, SUITE 9, WILLOUGHBY HILLS, OH 44094-8480
(440) 585-5258
(440) 944-5278
Mailing address
34600 CHARDON RD, SUITE 9, WILLOUGHBY HILLS, OH 44094-8480
(440) 585-5258
(440) 944-5278

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
35036891
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
34136753400
TAX ID
OH
01
35036891
OHIO LICENSE
OH
Enumeration date
09/28/2006
Last updated
06/16/2010
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