NPI 1649488255 · live from the CMS NPI Registry
Ivan John Christov Nicolov, M.D.
Family Medicine, Hospice and Palliative Medicine in Pine Hill, NM. National Provider Identifier 1649488255, active.
NPI record
| NPI | 1649488255 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Family Medicine, Hospice and Palliative Medicine 207QH0002X |
| Practice location | Bia Rte 125, Pine Hill, NM 87357 |
| Practice phone | 505-775-3271 |
| Mailing address | Bia Rte 125, 310, Pine Hill, NM 87357 |
| Enumerated | May 18, 2007 |
| Last updated | July 8, 2007 |
| Sole proprietor | Yes |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Family Medicine, Hospice and Palliative Medicine primary | 207QH0002X | MD20060115 (NM) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.