Surdock, Nicole Marie

Surdock, Nicole Marie is an sole proprietor health care provider with primary practice located at 47 Penny Ln Suite 1, Watsonville CA 95076-6055. She recently has 2 registered licenses in different health care specialties including Podiatric Medicine & Surgery Service Providers / Primary Podiatric Medicine, Podiatric Medicine & Surgery Service Providers / Foot & Ankle Surgery. Podiatric Medicine & Surgery Service Providers / Primary Podiatric Medicine is her primary health care specialty. Surdock, Nicole Marie can be contacted via phone (831) 728-8844.

Contact Information

Primary practice address
47 Penny Ln Suite 1 Watsonville CA 95076-6055
Phone: (831) 728-8844
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Podiatric Medicine & Surgery Service Providers / Primary Podiatric Medicine 213EP1101X E4802 California
Podiatric Medicine & Surgery Service Providers / Foot & Ankle Surgery 213ES0103X EL 1671 California

Profile Details

NPI number 1174674436
LBN Legal business name Surdock, Nicole Marie
Credentials Doctor of Podiatric Medicine (DPM)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jan 15th, 2007
Last updated Feb 7th, 2012 - about 12 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 1174674436 NPPES
California Other EL 1671 D.P.M. RESIDENT'S LICENSE
California Other E 4802 D.P.M. RESIDENT'S LICENSE

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