Individual
BRIAN NICHELSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
1 GENESYS PKWY, GRAND BLANC, MI 48439-8065
(810) 606-5000
Mailing address
2144 BRETON RD SE, GRAND RAPIDS, MI 49546-5574
(517) 795-0194
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
5101017702
MI
Other
Enumeration date
06/11/2008
Last updated
06/11/2008
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