Individual
DR. NICOLAS MARCUS PRISCU
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
8111 S EMERSON AVE FL 5, INDIANAPOLIS, IN 46237-8601
(317) 528-8930
(317) 528-8532
Mailing address
PO BOX 781076, DETROIT, MI 48278-1076
(317) 528-4800
(317) 865-1479
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
01039800A
IN
207RH0002X
Hospice and Palliative Medicine (Internal Medicine) Physician
Primary
01039800A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000042357
MPLAN
IN
01
—
000000578061
ANTHEM
IN
01
—
01039800B
CSR
IN
05
—
100350980
—
IN
01
—
10825775
CAQH
IN
Enumeration date
11/16/2005
Last updated
09/28/2023
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