Individual
BRET ANTHONY NICKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
MEDICAL CENTER BLVD, WINSTON SALEM, NC 27157-0001
(336) 716-2255
Mailing address
PO BOX 602598, WAKE FOREST UNIVERSITY HEALTH SCIENCES, CHARLOTTE, NC 25260-2598
(336) 716-2255
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
200400721
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
891365W
—
NC
Enumeration date
11/30/2005
Last updated
09/12/2011
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