Individual
DR. NICKLAS B OLDENBURG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
825 N MAIN ST, PROVIDENCE, RI 02904-5707
(401) 521-9700
(401) 751-1686
Mailing address
825 N MAIN ST, PROVIDENCE, RI 02904-5767
(401) 521-9700
(401) 751-1686
Taxonomy
Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
Primary
10931
RI
2085R0001X
Radiation Oncology Physician
205005
MA
2085R0001X
Radiation Oncology Physician
Primary
MD10931
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110000497A
—
MA
05
—
7009934
—
RI
01
—
920007190
RR MEDICARE
RI
Enumeration date
05/24/2005
Last updated
03/10/2026
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