Individual
DR. BRENDON NICHOLSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4100 W 3RD ST, DAYTON, OH 45428-9000
(937) 268-6511
Mailing address
4100 W 3RD ST, DAYTON, OH 45428-9000
(937) 268-6511
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
00022297
AL
Other
Enumeration date
10/19/2006
Last updated
07/08/2007
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