Provider Demographics
NPI:1366418790
Name:NICHOLS, CARTER J (MD)
Entity type:Individual
Prefix:DR
First Name:CARTER
Middle Name:J
Last Name:NICHOLS
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:7450 FRANCE AVE S
Mailing Address - Street 2:SUITE 100
Mailing Address - City:EDINA
Mailing Address - State:MN
Mailing Address - Zip Code:55435-4787
Mailing Address - Country:US
Mailing Address - Phone:952-832-8100
Mailing Address - Fax:952-832-8176
Practice Address - Street 1:7450 FRANCE AVE S
Practice Address - Street 2:SUITE 100
Practice Address - City:EDINA
Practice Address - State:MN
Practice Address - Zip Code:55435-4787
Practice Address - Country:US
Practice Address - Phone:952-832-8100
Practice Address - Fax:952-832-8176
Is Sole Proprietor?:No
Enumeration Date:2006-02-25
Last Update Date:2007-07-08
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Provider Licenses
StateLicense IDTaxonomies
MN34419207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN105073OtherPATIENT CHOICE
MN2F671NIOtherBLUE CROSS BLUE SHIELD
MN23387OtherAMERICA'S PPO/TPA
MN0800014OtherMEDICA DUEL SOLUTIONS
MN960560305008OtherPREFERRED ONE
MNF21442OtherHEALTH PARTNERS
MN0824658OtherMEDICA
MNF21442OtherHEALTH PARTNERS