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General NPI Number Information
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NPI Number | 1235575242
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Entity Type | Individual
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Provider Name | NICHOLAS L BEHUNIN M.D.
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Gender | Male
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Dates
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Enumeration Date | 05/16/2013
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Last Update Date | 08/28/2019
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Provider Practice Location Address
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Address Line | 1000 WALL STREET
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City | ANN ARBOR
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State | MI
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Zip | 48105-1912
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Country | US
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Telephone | 734-764-4190
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Fax |
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Provider Business Mailing Address
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Address Line | 617 E RIVERSIDE DR STE 101
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City | SAINT GEORGE
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State | UT
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Zip | 84790-8720
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Country | US
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Telephone | 435-628-4507
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | R73773
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License Number State | AZ
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Taxonomy #2
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | 4301111924
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License Number State | MI
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