Wickersham, Nicholas Wendell
Wickersham, Nicholas Wendell is an sole proprietor health care provider with primary practice located at 1100 Balsam Ave , Boulder CO 80304-3404. He recently has only one registered license in Allopathic & Osteopathic Physicians / Diagnostic Radiology, which is considered as his primary health care specialty. Wickersham, Nicholas Wendell can be contacted via phone (303) 532-3500.Contact Information
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Allopathic & Osteopathic Physicians / Diagnostic Radiology | 2085R0202X | 47842 | Colorado |
Profile Details
NPI number | 1396867222 |
---|---|
LBN Legal business name | Wickersham, Nicholas Wendell |
Credentials | Doctor of Medicine (MD) |
Entity | Individual |
Sole proprietor 1 | Yes |
Enumeration date | Apr 3rd, 2007 |
Last updated | Mar 15th, 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.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1396867222 | NPPES |
Colorado | MEDICAID | 07101759 |
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