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General NPI Number Information
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NPI Number | 1689679631
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Entity Type | Individual
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Provider Name | DONALD THOMAS NICELL M.D.
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Gender | Male
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Dates
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Enumeration Date | 06/16/2005
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Last Update Date | 02/05/2025
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Provider Practice Location Address
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Address Line | 3600 MINNESOTA DR STE 800
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City | EDINA
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State | MN
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Zip | 55435-7915
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Country | US
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Telephone | 952-595-1301
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Fax | 612-294-4903
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Provider Business Mailing Address
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Address Line | 3600 MINNESOTA DR STE 800
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City | EDINA
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State | MN
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Zip | 55435-7915
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Country | US
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Telephone | 952-595-1301
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Fax | 612-294-4903
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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 | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | MD423498
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | E0761
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License Number State | AR
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Taxonomy #3
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 042-0010894
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License Number State | VT
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Taxonomy #4
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | MD.15599R
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License Number State | LA
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Taxonomy #5
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | ME91391
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License Number State | FL
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