Healthcare Provider Details

I. General information

NPI: 1720601172
Provider Name (Legal Business Name): NICOLAS H PARNELL MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/20/2020
Last Update Date: 06/30/2026
Certification Date: 06/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1500 EAST MEDICAL CENTER DRIVE MEDICAL PROFESSIONAL BUILDING D5101
ANN ARBOR MI
48109
US

IV. Provider business mailing address

1500 EAST MEDICAL CENTER DRIVE MEDICAL PROFESSIONAL BUILDING D5101
ANN ARBOR MI
48109
US

V. Phone/Fax

Practice location:
  • Phone: 616-502-4022
  • Fax:
Mailing address:
  • Phone: 616-502-4022
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2080P0207X
TaxonomyPediatric Hematology & Oncology Physician
License Number4301509077
License Number StateMI
# 2
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number4301509077
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: