Individual
NICHOLAS ADAM NETHERLAND
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
195 KIMEL PARK DR STE 200, WINSTON SALEM, NC 27103-6967
(336) 768-6211
(336) 768-6869
Mailing address
2025 FRONTIS PLAZA BLVD, SUITE 200, WINSTON SALEM, NC 27103-5663
(336) 768-6211
(336) 768-6869
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
2008-01558
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2073599
MEDICARE
NC
Enumeration date
10/02/2006
Last updated
08/08/2024
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