Individual
NICHOLAS HELLER LAKE
Active
Individual
NICHOLAS HELLER LAKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
171000000X
Military Health Care Provider
—
—
207X00000X
Orthopaedic Surgery Physician
2020-02932
NC
207XS0106X
Orthopaedic Hand Surgery Physician
Primary
29393
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0397730007
NSC#
NC
Enumeration date
05/27/2015
Last updated
08/23/2022
Update your record
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