Paul Nicholasen, MD

Individual provider Active NPI Internal Medicine Physician · Newark, DE

NPI 1992783757 · NPPES record last updated Jun 27, 2011

Key facts

NPI
1992783757
Entity type
Individual (NPI type 1)
Primary specialty
Internal Medicine Physician 207R00000X
License
C10002607 (DE)
Practice address
200 Hygeia Dr
Newark, DE 19713-2049
Phone
(302) 623-0100
Fax
(302) 623-0227
NPI assigned
Jan 3, 2006
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
C10002607DEMDInternal Medicine Physician

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X C10002607 DE Yes

Addresses

Primary practice location

200 Hygeia Dr
Newark, DE 19713-2049

Mailing address

200 Hygeia Dr
Newark, DE 19713-2049
Phone (302) 623-0100

Other providers in Newark, DE

All providers in Newark, DE · Internal Medicine Physician in Delaware

Sources for this page

Verify at the official NPI Registry.