Healthcare Provider Details

I. General information

NPI: 1952313215
Provider Name (Legal Business Name): NICHOLAS L FINLEY MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/13/2006
Last Update Date: 10/01/2020
Certification Date: 10/01/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2235 DUBOIS DR
WARSAW IN
46580-3212
US

IV. Provider business mailing address

6920 POINTE INVERNESS WAY STE 200
FORT WAYNE IN
46804-7934
US

V. Phone/Fax

Practice location:
  • Phone: 574-267-8189
  • Fax: 574-267-7554
Mailing address:
  • Phone: 260-479-3513
  • Fax: 260-479-3520

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number01061059
License Number StateIN
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number01061059A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: