Individual
RUDY J NICOLAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
611 UNIVERSITY DR, 611 MRI, STATE COLLEGE, PA 16801-6552
(814) 234-2600
(814) 867-5285
Mailing address
611 UNIVERSITY DR, 611 MRI, STATE COLLEGE, PA 16801-6552
(814) 234-2600
(814) 867-5285
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
683230
—
PA
Enumeration date
07/06/2006
Last updated
07/08/2007
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