Provider Demographics
NPI:1053602755
Name:NICHOLS, JOSEPH SCOTT (MD, MPH)
Entity type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:SCOTT
Last Name:NICHOLS
Suffix:
Gender:M
Credentials:MD, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7000 CARROLL AVE STE 200A
Mailing Address - Street 2:
Mailing Address - City:TAKOMA PARK
Mailing Address - State:MD
Mailing Address - Zip Code:20912-4437
Mailing Address - Country:US
Mailing Address - Phone:301-578-2388
Mailing Address - Fax:855-612-2683
Practice Address - Street 1:7000 CARROLL AVE STE 200A
Practice Address - Street 2:
Practice Address - City:TAKOMA PARK
Practice Address - State:MD
Practice Address - Zip Code:20912-4437
Practice Address - Country:US
Practice Address - Phone:301-578-2388
Practice Address - Fax:855-612-2683
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-28
Last Update Date:2022-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0077593207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine