Individual
WILL NICHOLSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1414 MARYLAND AVE E, SAINT PAUL, MN 55106-2824
(651) 722-3461
(651) 772-2605
Mailing address
2590 BITTERSWEET LN, MAPLEWOOD, MN 55109-2104
(651) 470-5522
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
NONE
MN
Other
Enumeration date
05/09/2007
Last updated
07/08/2007
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