Basic Information
| Provider Information | |||||||||
| NPI: | 1326278862 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | ABEL | ||||||||
| FirstName: | NICHOLAS | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 217 APPLE TREE LN | ||||||||
| Address2: | |||||||||
| City: | WAKARUSA | ||||||||
| State: | IN | ||||||||
| PostalCode: | 465739702 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2488859835 | ||||||||
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| Practice Location | |||||||||
| Address1: | 620 W EDISON RD STE 110 | ||||||||
| Address2: | |||||||||
| City: | MISHAWAKA | ||||||||
| State: | IN | ||||||||
| PostalCode: | 465452784 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5742581100 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 07/17/2009 | ||||||||
| LastUpdateDate: | 06/11/2015 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 4301094674 | MI | N | Allopathic & Osteopathic Physicians | Internal Medicine | 2085R0202X | 4301094674 | MI | Y | Allopathic & Osteopathic Physicians | Radiology | Diagnostic Radiology | 2085R0202X | 01074601A | IN | N | Allopathic & Osteopathic Physicians | Radiology | Diagnostic Radiology |
No ID Information.