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Individual

DR. MICAH KIRK NIELSEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
5495 S RAINBOW BLVD STE 101, LAS VEGAS, NV 89118-1872
(702) 477-0772
Mailing address
PO BOX 30077, SALT LAKE CITY, UT 84130-0077
(702) 477-0772

Taxonomy

Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
15404
NV
2085R0202X
Diagnostic Radiology Physician
35.120645
OH

Other

Enumeration date
08/01/2008
Last updated
10/20/2017
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