Individual
NICHOLAS MICHAEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
8901 WISCONSIN AVE, BETHESDA, MD 20889-0004
(814) 574-6560
Mailing address
PSC 1005, BOX 110185, FPO, AA 34009
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
0101270245
VA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/05/2019
Last updated
07/08/2025
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