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NPI Code Detail

MEDICARE: DR. AARON NICHOLS OD

MEDICARE:  DR. AARON  NICHOLS  OD
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
1152W00000XOptometrist3.003085CT
2152W00000XOptometrist4901005401MI

General Provider Information

NPI Number : 1689160145
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. AARON NICHOLS OD
Provider Business Mailing Address
First Line : 48189 VAN DYKE AVE
Second Line :
City : SHELBY TOWNSHIP
State : MI
Zip : 48317-3268
Country : US
Telephone Number : 586-731-9725
Fax Number :
Provider Business Practice Location Address
First Line : 48189 VAN DYKE AVE
Second Line :
City : SHELBY TOWNSHIP
State : MI
Zip : 48317-3268
Country : US
Telephone Number : 586-731-9725
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/09/2018
Last Update Date : 01/31/2023

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Directions to “ DR. AARON NICHOLS OD” Practice Location

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