Male or Other

Gary L. Nicholson M.D.

Hematology & Oncology Physician in Kettering, OH(View on Map)

Full Name

Gary L Nicholson M.D.

NPI Number

1407806474

NPI Type

Individual Provider

Gender

Male

Enumeration Date

05/11/2006

Specialties

(Taxonomies)

Code

207RH0003X

Primary Taxonomy

Yes

Licenses

State

Ohio

License Number

35034705

Contact
Information

Purpose

Mailing
Location

Address

2264 BERRYCREEK DR
3120 GOVERNORS PLACE BLVD

City

Kettering
Kettering

State

OH
OH

Postal Code

45440-2621
45409-1328

Country

US
US

Telephone Number

N/A
(937) 293-1622

Identifiers

Identifier

0330270

Identifier State

OH

Identifier Issuer

Unknown

Provider data last refreshed from NPPES NPI registry on 11/19/2024

Data last updated by provider on 07/09/2007

Provider Address

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