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NPI Code Detail

MEDICARE: NICHOLAS AHERN MD

MEDICARE:   NICHOLAS  AHERN  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
1207PH0002XHospice and Palliative Medicine (Emergency Medicine) Physician8634665-1205UT
2207QH0002XHospice and Palliative Medicine (Family Medicine) Physician347100LA
3207Q00000XFamily Medicine PhysicianR79282AZ

General Provider Information

NPI Number : 1720723349
Entity Type Code : Individual
Provider Name (Legal Business Name) : NICHOLAS AHERN MD
Provider Business Mailing Address
First Line : PO BOX 30180
Second Line :
City : SALT LAKE CITY
State : UT
Zip : 84130-0180
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1430 TULANE AVE # 8016
Second Line :
City : NEW ORLEANS
State : LA
Zip : 70112-2632
Country : US
Telephone Number : 504-988-9963
Fax Number : 504-988-9963
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/28/2022
Last Update Date : 05/26/2026

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Directions to “ NICHOLAS AHERN MD” Practice Location

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