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General NPI Number Information
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NPI Number | 1528219417
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Entity Type | Individual
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Provider Name | NICHOLA CAROLYN WILSON MBCHB
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Gender | Female
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Dates
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Enumeration Date | 10/09/2008
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Last Update Date | 10/09/2008
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Provider Practice Location Address
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Address Line | 601 N CAROLINE ST JHOC # 5215 JOHNS HOPKINS DEPARTMENT OF ORTHOPAEDIC SURGERY
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City | BALTIMORE
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State | MD
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Zip | 21287-0001
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Country | US
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Telephone | 410-955-8344
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Fax |
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Provider Business Mailing Address
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Address Line | 6601 BONNIE RIDGE DR APT 102
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City | BALTIMORE
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State | MD
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Zip | 21209-1922
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Country | US
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Telephone | 443-857-6147
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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 | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | 23741
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License Number State | MD
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