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General NPI Number Information
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NPI Number | 1821130402
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Entity Type | Organization
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Legal Business Name | NICHOLAS SHOLTY MD PA
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Dates
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Enumeration Date | 02/12/2007
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Last Update Date | 01/28/2009
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Provider Practice Location Address
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Address Line | 4707 N DAVIS HWY
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City | PENSACOLA
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State | FL
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Zip | 32503
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Country | US
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Telephone | 850-857-4888
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Fax | 850-857-1255
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Provider Business Mailing Address
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Address Line | 4707 N DAVIS HWY
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City | PENSACOLA
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State | FL
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Zip | 32503
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Country | US
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Telephone | 850-857-4888
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Fax | 850-857-1255
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Authorized Official
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Title or Position | OFFICE ADMINISTRATOR
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Name | MRS. PEGGY LYNN SHOLTY
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Credential |
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Telephone | 850-857-4888
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 49156
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License Number State | FL
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