Provider Demographics
NPI:1053800375
Name:DOWNS, NICHOLAS O'HARA (DO)
Entity type:Individual
Prefix:
First Name:NICHOLAS
Middle Name:O'HARA
Last Name:DOWNS
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 13008
Mailing Address - Street 2:
Mailing Address - City:LANSING
Mailing Address - State:MI
Mailing Address - Zip Code:48901-3008
Mailing Address - Country:US
Mailing Address - Phone:517-253-6320
Mailing Address - Fax:517-253-6321
Practice Address - Street 1:1200 E MICHIGAN AVE STE 245A
Practice Address - Street 2:
Practice Address - City:LANSING
Practice Address - State:MI
Practice Address - Zip Code:48912-1852
Practice Address - Country:US
Practice Address - Phone:517-364-5710
Practice Address - Fax:517-364-5717
Is Sole Proprietor?:No
Enumeration Date:2018-05-02
Last Update Date:2021-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5101026084207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine