Paul G. Nicholas Iii, D.o., P.a. | |
24 East Ave Woodstown NJ 08098-1409 | |
(856) 769-0900 | |
(856) 769-2639 |
Full Name | Paul G. Nicholas Iii, D.o., P.a. |
---|---|
Speciality | Family Medicine |
Location | 24 East Ave, Woodstown, New Jersey |
Authorized Official Name and Position | Paul Nicholas (PHYSICIAN) |
Authorized Official Contact | 8567690900 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
Paul G. Nicholas Iii, D.o., P.a. Po Box 304 24 East Ave Woodstown NJ 08098-0304 Ph: (856) 769-0900 | Paul G. Nicholas Iii, D.o., P.a. 24 East Ave Woodstown NJ 08098-1409 Ph: (856) 769-0900 |
NPI Number | 1346462983 |
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Provider Enumeration Date | 05/03/2007 |
Last Update Date | 08/22/2020 |
Medicare PECOS PAC ID | 7810162021 |
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Medicare Enrollment ID | O20111215000684 |
Identifier | Type | State | Issuer |
---|---|---|---|
1346462983 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | MB040789 (New Jersey) | Primary |
Provider Name | Paul G Nicholas |
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Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1609898022 PECOS PAC ID: 8729253935 Enrollment ID: I20111215000739 |
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