Healthcare Provider Details

I. General information

NPI: 1891181012
Provider Name (Legal Business Name): NICHOLAS GOLINVAUX M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/14/2015
Last Update Date: 12/24/2024
Certification Date: 12/24/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

75 FRANCIS ST
BOSTON MA
02115-6110
US

IV. Provider business mailing address

601 E HAMPDEN AVE STE 500
ENGLEWOOD CO
80113-2771
US

V. Phone/Fax

Practice location:
  • Phone: 617-732-5384
  • Fax:
Mailing address:
  • Phone: 303-744-7078
  • Fax: 303-777-4563

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207XS0106X
TaxonomyOrthopaedic Hand Surgery Physician
License NumberDR.0065921
License Number StateCO
# 2
Primary TaxonomyN
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number282426
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: