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Individual

DR. NICHOLAS MARK MESSAMER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
410 N 12TH ST, OSKALOOSA, IA 52577-2495
(641) 672-3360
(641) 672-3366
Mailing address
410 N 12TH ST, OSKALOOSA, IA 52577-2495
(641) 672-3360
(641) 672-3366

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
27198
IA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0000
TRICARE
01
080123337
RR MEDICARE
01
16D0950498
CLIA
01
46158
BLUE CROSS BLUE SHIELD
IA
01
5008800001
CMS
05
7050880
IA
01
7815
MIDLAND CHOICE
01
IA0101
JOHN DEERE
IA
Enumeration date
09/09/2005
Last updated
12/05/2012
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