MEDICARE: NICHOLAS MIDDAUGH

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	106S00000X	Behavior Technician	1619701323	MI

General Provider Information

NPI Number	:	1619701323
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NICHOLAS MIDDAUGH

Provider Business Mailing Address
First Line	:	181 E HURON AVE
Second Line	:
City	:	BAD AXE
State	:	MI
Zip	:	48413-1314
Country	:	US
Telephone Number	:	810-309-8134
Fax Number	:

Provider Business Practice Location Address
First Line	:	590 N PORT CRESCENT ST
Second Line	:
City	:	BAD AXE
State	:	MI
Zip	:	48413-1209
Country	:	US
Telephone Number	:	810-309-8134
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/27/2024
Last Update Date	:	12/22/2025

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Directions to “ NICHOLAS MIDDAUGH ” Practice Location

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