Provider Demographics
NPI:1033288634
Name:NICHOLAS, ERIC FINLAY (MD)
Entity type:Individual
Prefix:
First Name:ERIC
Middle Name:FINLAY
Last Name:NICHOLAS
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:PO BOX 450
Mailing Address - Street 2:15 HIGHLAND AVE
Mailing Address - City:MARS HILL
Mailing Address - State:ME
Mailing Address - Zip Code:04758-0450
Mailing Address - Country:US
Mailing Address - Phone:207-429-9133
Mailing Address - Fax:
Practice Address - Street 1:15 HIGHLAND AVE
Practice Address - Street 2:
Practice Address - City:MARS HILL
Practice Address - State:ME
Practice Address - Zip Code:04758-0450
Practice Address - Country:US
Practice Address - Phone:207-429-9133
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-07
Last Update Date:2010-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME5469207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
011774477OtherTRAVELERS MEDICARE
ME103130000Medicaid
005816OtherANTHEM
1041359OtherAETNA
M86010COtherCIGNA
010267753001OtherFED BCBS
M86011COtherCIGNA
ME103130000Medicaid
M86011COtherCIGNA