Individual
AJ DUANE NICHOLAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
47149 BUSE RD BLDG 1370, PATUXENT RIVER, MD 20670-1540
(301) 342-1499
Mailing address
47311 SILVER SLATE DR, LEXINGTON PARK, MD 20653-2448
(772) 713-9786
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
—
—
Other
Enumeration date
12/21/2021
Last updated
12/21/2021
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