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General NPI Number Information
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NPI Number | 1407218571
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Entity Type | Individual
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Provider Name | ANTHONY JOHN NICOLAS M.D.
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Gender | Male
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Dates
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Enumeration Date | 03/28/2016
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Last Update Date | 08/11/2021
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Provider Practice Location Address
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Address Line | 3601 5TH AVE STE 2B
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City | PITTSBURGH
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State | PA
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Zip | 15213-3403
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Country | US
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Telephone | 412-605-3924
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Fax | 412-692-4313
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Provider Business Mailing Address
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Address Line | 3601 5TH AVE STE 2B
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City | PITTSBURGH
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State | PA
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Zip | 15213-3403
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Country | US
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Telephone | 412-605-3924
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Fax | 412-692-4313
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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 | 207RR0500X
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Taxonomy Name | Rheumatology Physician
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License Number | MD473332
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License Number State | PA
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