Individual
DR. MICHAEL DAVID NICKERSON JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2817 ROCK MERRITT AVE STOP A, FORT LIBERTY, NC 28310-7394
(910) 908-2318
Mailing address
2817 ROCK MERRITT AVE STOP A, FORT LIBERTY, NC 28310-0001
(910) 907-8707
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
0101246915
VA
207L00000X
Anesthesiology Physician
Primary
2019-02595
NC
207L00000X
Anesthesiology Physician
Q4227
TX
Other
Enumeration date
03/24/2009
Last updated
01/01/2025
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