Individual
DR. LLOYD EMERY NICKERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1811 E INNES ST, SALISBURY, NC 28146-6030
(704) 216-8777
(704) 638-3129
Mailing address
1811 E INNES ST, SALISBURY, NC 28146-6030
(704) 216-8777
(704) 638-3129
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
38151
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01-41632
UNITED HEALTHCARE
NC
01
—
0138R
BLUECROSS GROUP ID
NC
05
—
1942382940
—
NC
01
—
202595
BLACK LUNG ID
NC
01
—
2723
HEALTHSOURCE
NC
01
—
28472
MAMSI ID
NC
01
—
38151
STATE LICENSE
NC
01
—
3926
PARTNERS ID
NC
01
—
561794820
PRUDENTIAL ID
NC
01
—
62644
BCBS PERSONAL ID
NC
05
—
890138R
—
NC
05
—
8962644
—
NC
Enumeration date
10/19/2006
Last updated
03/07/2023
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