| Harold R Nicolette, Do, Pa | |
|
6 Carriage Ln Suite B Charleston SC 29407-6010 | |
| (843) 766-4100 | |
| (843) 571-4177 |
| Full Name | Harold R Nicolette, Do, Pa |
|---|---|
| Speciality | Family Medicine |
| Location | 6 Carriage Ln, Charleston, South Carolina |
| Authorized Official Name and Position | Harold Roy Nicolette (PRESIDENT) |
| Authorized Official Contact | 8437664100 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Harold R Nicolette, Do, Pa 6 Carriage Ln Suite B Charleston SC 29407-6010 Ph: (843) 766-4100 | Harold R Nicolette, Do, Pa 6 Carriage Ln Suite B Charleston SC 29407-6010 Ph: (843) 766-4100 |
| NPI Number | 1043478142 |
|---|---|
| Provider Enumeration Date | 05/27/2008 |
| Last Update Date | 05/27/2008 |
| Medicare PECOS PAC ID | 9335219260 |
|---|---|
| Medicare Enrollment ID | O20080604000615 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1043478142 | NPI | - | NPPES |
| 001651 | Medicaid | SC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 0165 (South Carolina) | Primary |
| Provider Name | Robert Karl Hetz |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1831175165 PECOS PAC ID: 6608056668 Enrollment ID: I20110208000483 |
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