Individual
NICHOLAS GEORGE LAILAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
0101054583
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1750376539
—
VA
05
—
30016055850001
—
VA
01
—
340017875
RR MEDICARE VA
VA
01
—
340017876
RRMEDICARE
DC
Enumeration date
09/16/2005
Last updated
03/18/2024
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