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General NPI Number Information
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NPI Number | 1982677233
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Entity Type | Individual
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Provider Name | FRED MICHAEL NICHOLS DO
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Gender | Male
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Dates
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Enumeration Date | 02/08/2006
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Last Update Date | 11/10/2025
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Provider Practice Location Address
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Address Line | 530 NEW BRUNSWICK AVE
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City | PERTH AMBOY
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State | NJ
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Zip | 08861-3654
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Country | US
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Telephone | 732-324-3300
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Fax | 732-324-3259
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Provider Business Mailing Address
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Address Line | 3421 CONCORD RD
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City | YORK
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State | PA
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Zip | 17402-9001
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Country | US
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Telephone | 717-273-8835
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Fax | 717-202-0100
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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 | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | OS009392L
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | FN7479430
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License Number State | PA
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Taxonomy #3
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | C2-0023893
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License Number State | DE
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Taxonomy #4
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 25MB05813300
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License Number State | NJ
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