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Individual

BRIAN SCOTT NISHEK

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
OD

Contact information

Practice address
324 N HIGHWAY 16, DENVER, NC 28037-8012
(704) 483-2263
(704) 483-6136
Mailing address
324 N HIGHWAY 16, DENVER, NC 28037-8012
(704) 483-2263
(704) 483-6136

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1819
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
093MV
BCBS
NC
05
89093MV
NC
Enumeration date
11/09/2005
Last updated
12/04/2012
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