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Individual

DR. MICHAEL C. NICHOLS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
81-948 WAENA 'OIHANA LOOP, SUITE 120, CKC BUILDING 9, KEALAKEKUA, HI 96750
(808) 322-6692
(808) 322-6693
Mailing address
PO BOX 319, KEALAKEKUA, HI 96750-0319
(808) 322-6692
(808) 322-6693

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MD4571
HI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
011527-01
HI
Enumeration date
07/12/2006
Last updated
07/08/2007
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