Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RC0000X | Internist - Cardiovascular Disease | 35-046669 | OH |
Y | 207RC0001X | Clinical Cardiac Electrophysiologist | 35-046669 | OH |
NPI | 1184621575 |
---|---|
Provider Name | Dr. Allan J Nichols |
First Address | Dublin, OH 43016-4259 |
Second Address | Columbus, OH 43214-3467 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/06/2005 |
Last Update Date | 25/02/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0775942 | (05) | OH |
D33284 | (02) | OH |