Nickodem, Robert J
Nickodem, Robert J is an individual health care provider with primary practice located at 7060 Wayside Dr Mtr1/-102, Mentor OH 44060-6527. He recently has only one registered license in Allopathic & Osteopathic Physicians / Orthopaedic Surgery, which is considered as his primary health care specialty. Nickodem, Robert J can be contacted via phone (440) 357-2770.Contact Information
Primary practice address
7060 Wayside Dr Mtr1/-102
Mentor OH 44060-6527
Phone: (440) 357-2770
Fax: (440) 354-4669
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Orthopaedic Surgery | 207X00000X | 35-05-1872-N | Ohio |
Profile Details
| NPI number | 1790707966 |
|---|---|
| LBN Legal business name | Nickodem, Robert J |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 24th, 2006 |
| Last updated | Feb 5th, 2013 - about 11 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1790707966 | NPPES |
| Ohio | MEDICAID | 0594110 |
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