Individual
DR. NICHOLAS DOMINIC COLACCHIO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
2017-00044
NC
207X00000X
Orthopaedic Surgery Physician
Primary
MD21891
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2017-00044
MEDICAL LICENSE
NC
Enumeration date
06/08/2012
Last updated
12/03/2018
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