Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207X00000X | Orthopaedic Surgeon | 2004-01658 | NC |
Y | 207X00000X | Orthopaedic Surgeon | 57734 | GA |
N | 207X00000X | Orthopaedic Surgeon | MD30266 | SC |
N | 207XX0004X | Foot and Ankle Orthopaedic Surgeon | 57734 | GA |
NPI | 1821071044 |
---|---|
Provider Name | Dr. Christopher W Nicholson |
First Address | Savannah, GA 31405 |
Second Address | Savannah, GA 31405-6736 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/11/2005 |
Last Update Date | 30/10/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
5901024 | (05) | NC |
788032045F | (05) | GA |
H77532 | (02) | |
H77532 | (02) | NC |
N01659 | (05) | SC |