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NPI Code Detail

MEDICARE: MICHAEL S NILLAS MD

MEDICARE: MICHAEL S NILLAS MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207RC0000XCardiovascular Disease PhysicianMD434384PA
2207RC0000XCardiovascular Disease Physician25MA08101400NJ

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1649282658
Entity Type Code : Individual
Provider Name (Legal Business Name) : MICHAEL S NILLAS MD
Provider Business Mailing Address
First Line : 1 FEDERAL ST STE 200
Second Line :
City : CAMDEN
State : NJ
Zip : 08103-1088
Country : US
Telephone Number : 848-288-6935
Fax Number : 732-790-0107
Provider Business Practice Location Address
First Line : 217 N MAIN ST STE 205
Second Line :
City : CAPE MAY COURT HOUSE
State : NJ
Zip : 08210-2104
Country : US
Telephone Number : 609-463-5440
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/12/2006
Last Update Date : 05/08/2024

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