Nicholas Wendell Wickersham M.D.

NPI 1396867222 - Radiology - 2085R0202X

NPI Details
NPI 1396867222
Gender Male
Enumeration Date 04/03/2007
Last Updated 03/22/2016
Entity Type Individual
Active Over 9 years ago
Practice Location
36 GARDEN CTR
BROOMFIELD CO, 80020-1730, US
Phone (303) 465-0401
Fax (303) 438-1351
Business Location
2218 MAPLETON AVE
BOULDER CO, 80304-3749, US
Phone (509) 954-6557
Fax
Toxanomy
Taxonomy Code 2085R0202X
License State Colorado
License Number 47842
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According to our database, Nicholas Wendell Wickersham M.D. NPI is 1396867222, taxonomy code is 2085R0202X and license number is 47842, license state is located at Colorado. Nicholas Wendell Wickersham M.D. physically located at 36 Garden Ctr, Broomfield CO, 80020-1730. NPI Number Nicholas Wendell Wickersham M.D. has the Individual type.

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1396867222 NPI number is provided on an as is basis without warranty of any kind. 1396867222 is maintained by the National Plan & Provider Enumeration System. The contents of Nicholas Wendell Wickersham M.D. are for informational purposes only.