Individual
CHRISTOPHER W NICKUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.A.
Contact information
Practice address
1365A CLIFTON RD NE, ATLANTA, GA 30322-1013
(404) 778-3481
(404) 778-5585
Mailing address
10620 TUXFORD DR, ALPHARETTA, GA 30022-7067
(678) 393-1509
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
005050
GA
363AS0400X
Surgical Physician Assistant
PA3218
FL
Other
Enumeration date
03/27/2006
Last updated
07/08/2007
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