Individual
NICHOLAS PELLICCIO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
6025 WALNUT GROVE RD STE 301, MEMPHIS, TN 38120-2123
(901) 226-0458
Mailing address
965 RIDGE LAKE BLVD, MEMPHIS, TN 38120-9401
(901) 227-4692
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
33099
MS
2086S0129X
Vascular Surgery Physician
Primary
33099
MS
Other
Enumeration date
03/31/2017
Last updated
07/28/2024
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