Nikicicz, Edward Peter

Nikicicz, Edward Peter is an sole proprietor health care provider with primary practice located at 801 S Adams St Srmc, Lab, Petersburg VA 23803-5149. He recently has only one registered license in Allopathic & Osteopathic Physicians / Anatomic Pathology & Clinical Pathology, which is considered as his primary health care specialty. Nikicicz, Edward Peter can be contacted via phone (804) 862-5028.

Contact Information

Primary practice address
801 S Adams St Srmc, Lab Petersburg VA 23803-5149
Phone: (804) 862-5028
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Anatomic Pathology & Clinical Pathology 207ZP0102X VA0101047885 Virginia

Profile Details

NPI number 1639267040
LBN Legal business name Nikicicz, Edward Peter
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Oct 11th, 2006
Last updated Jul 2nd, 2009 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1639267040 NPPES
Virginia Other 086358 BCBS
Virginia MEDICAID 6600727 BCBS

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