Oldenburg, Nicklas B

Oldenburg, Nicklas B is an individual health care provider with primary practice located at 825 N Main St , Providence RI 02904-5707. He recently has only one registered license in Allopathic & Osteopathic Physicians / Radiation Oncology, which is considered as his primary health care specialty. Oldenburg, Nicklas B can be contacted via phone (401) 521-9700.

Contact Information

Primary practice address
825 N Main St Providence RI 02904-5707
Fax: (401) 751-1686
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Radiation Oncology 2085R0001X 10931 Rhode Island

Profile Details

NPI number 1801899760
LBN Legal business name Oldenburg, Nicklas B
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 24th, 2005
Last updated Feb 18th, 2016 - about 8 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 1801899760 NPPES
Rhode Island Other 920007190 RR MEDICARE
Rhode Island MEDICAID 110000497A RR MEDICARE
Rhode Island MEDICAID 7009934 RR MEDICARE

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