Individual
DR. THOMAS LOUIS NICKOLAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4921 PARKVIEW PL, DIV IM BONE AND MINERAL, STE 5C, SAINT LOUIS, MO 63110-1032
(314) 454-7775
(314) 996-3087
Mailing address
PO BOX 7412011, CHICAGO, IL 60674-2011
(314) 454-7775
(314) 996-3087
Taxonomy
Speciality
Code
Description
License number
State
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
Primary
2024049980
MO
207RN0300X
Nephrology Physician
2024049980
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200154745
—
MO
Enumeration date
11/30/2006
Last updated
04/17/2025
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