Individual
MARK LOVEL NICHOLS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
250 HOSPICE CIR, RALEIGH, NC 27607-6372
(919) 828-0890
(919) 719-0395
Mailing address
2425 COLEY FOREST PL, RALEIGH, NC 27612-4740
(919) 855-8911
(919) 855-9424
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
24472
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8962543
—
NC
Enumeration date
09/26/2005
Last updated
03/23/2011
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