Provider Demographics
NPI:1689701211
Name:NICHOL, DAVID ALBERT (MD)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:ALBERT
Last Name:NICHOL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1900 BLUFF ST
Mailing Address - Street 2:
Mailing Address - City:BOULDER
Mailing Address - State:CO
Mailing Address - Zip Code:80304-4287
Mailing Address - Country:US
Mailing Address - Phone:303-877-2270
Mailing Address - Fax:
Practice Address - Street 1:1900 BLUFF ST
Practice Address - Street 2:
Practice Address - City:BOULDER
Practice Address - State:CO
Practice Address - Zip Code:80304-4287
Practice Address - Country:US
Practice Address - Phone:720-381-6090
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-28
Last Update Date:2025-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO455362084P0800X, 102L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No102L00000XBehavioral Health & Social Service ProvidersPsychoanalyst