Individual
PAUL E NICHOLAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
405 W COLLEGE AVE STE F, SANTA ROSA, CA 95401-6506
(707) 547-5450
(707) 573-3555
Mailing address
405 W COLLEGE AVE STE F, SANTA ROSA, CA 95401-6506
(707) 547-5450
(707) 573-3555
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
A98793
CA
2084P0800X
Psychiatry Physician
47520
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
34606500
—
WI
Enumeration date
10/04/2006
Last updated
02/04/2021
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