Individual
DR. MICHAEL W NICHOLS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3917 WEST RD, #128, LOS ALAMOS, NM 87544-2275
(505) 662-4234
(505) 682-7894
Mailing address
3917 WEST RD, #126, LOS ALAMOS, NM 87544-2275
(505) 662-4234
(505) 662-7894
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
8298
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
51342
—
NM
Enumeration date
09/01/2005
Last updated
07/08/2007
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