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General NPI Number Information
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NPI Number | 1821447970
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Entity Type | Individual
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Provider Name | NICHOLAS MOLFETTA M.D.
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Gender | Male
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Dates
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Enumeration Date | 06/09/2016
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Last Update Date | 07/10/2020
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Provider Practice Location Address
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Address Line | 600 MARY ST
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City | EVANSVILLE
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State | IN
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Zip | 47710-1658
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Country | US
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Telephone | 812-450-5000
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Fax |
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Provider Business Mailing Address
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Address Line | 301 UNIVERSITY BLVD
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City | GALVESTON
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State | TX
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Zip | 77555-0877
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Country | US
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Telephone | 409-772-1221
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Fax | 409-772-1224
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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 | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | BP10057134
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License Number State | TX
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