Koutrelakos, Nicholas William

Koutrelakos, Nicholas William is an individual health care provider with primary practice located at 10710 Charter Dr Suite G020, Columbia MD 21044-3128. He recently has only one registered license in Allopathic & Osteopathic Physicians / Medical Oncology, which is considered as his primary health care specialty. Koutrelakos, Nicholas William can be contacted via phone (410) 964-2212.

Contact Information

Primary practice address
10710 Charter Dr Suite G020 Columbia MD 21044-3128
Phone: (410) 964-2212
Fax: (410) 964-0380
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Medical Oncology 207RX0202X D0038509 Maryland

Profile Details

NPI number 1912972415
LBN Legal business name Koutrelakos, Nicholas William
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 20th, 2006
Last updated Mar 18th, 2021 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1912972415 NPPES
Maryland MEDICAID 533151000

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