Individual
GARVIN NICKELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
9313 S MASON MONTGOMERY RD, STE. 200, MASON, OH 45040-8008
(513) 584-6999
(513) 584-6998
Mailing address
PO BOX 636256 CENTRAL CREDENTIALING, CINCINNATI, OH 45263-6256
(513) 585-5501
(513) 585-5511
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
35070234N
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2020986
—
OH
Enumeration date
04/12/2006
Last updated
01/26/2018
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