Evan A. Nicholas
Neuromusculoskeletal Medicine (NMM)
4190 City Line Ave
Philadelphia
, Pennsylvania 19131-1626
Evan A. Nicholas
Neuromusculoskeletal Medicine (NMM)
4190 City Line Ave
Philadelphia
, Pennsylvania 19131-1626
(215) 871-6490
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About
Features
Specialties
- Neuromusculoskeletal Medicine (NMM)
Languages spoken
- English
Location
First Address
- Evan A. Nicholas
- 4190 City Line Ave
- Philadelphia, PA
- Zip : 19131-1626
- Fax : (215) 871-6490
- Phone : (215) 871-6425
Second Address
- Evan A. Nicholas
- 4190 City Line Ave
- Philadelphia, PA
- Zip : 19131-1626
- Fax : (215) 871-6490
- Phone : (215) 871-6425
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 204D00000X | Neuromusculoskeletal Medicine (NMM) | OS004962L | PA |
National Provider Identifier
| NPI | 1457353336 |
|---|---|
| Provider Name | Evan A. Nicholas |
| First Address | Philadelphia, PA 19131-1626 |
| Second Address | Philadelphia, PA 19131-1626 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 11/08/2005 |
| Last Update Date | 01/02/2016 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| D98751 | (02) |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.