Individual
STEPHANIE L NICHOLAS
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1300 OXFORD DR, SUITE 2C, BETHEL PARK, PA 15102-1896
(412) 854-3121
Mailing address
1300 OXFORD DR, SUITE 2C, BETHEL PARK, PA 15102-1896
(412) 854-3121
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MD045471L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1305124
—
PA
Enumeration date
03/27/2006
Last updated
07/08/2007
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