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Individual

DR. NICHOLAS EUGENE MAKSIM

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.O., R.PH.

Contact information

Practice address
247 S BURNETT ROAD, SUITE 120, SPRINGFIELD, OH 45505
(740) 845-7700
(740) 845-7701
Mailing address
210 N MAIN STREET, LONDON, OH 43140-1115
(740) 845-7700
(740) 845-7701

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
58-001639
OH
207RC0000X
Cardiovascular Disease Physician
34.009062
OH
207RI0011X
Interventional Cardiology Physician
Primary
34009062
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
3147919
OH
Enumeration date
05/07/2007
Last updated
09/26/2024
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