Provider Demographics
NPI:1861697609
Name:BINGHAM, NICHOLAS D (MD)
Entity type:Individual
Prefix:
First Name:NICHOLAS
Middle Name:D
Last Name:BINGHAM
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:MERCY CARE OCCUPATIONAL HEALTH AT PRAIRIE CREEK
Mailing Address - Street 2:777 76TH AVE DR SW, SUITE 400
Mailing Address - City:CEDAR RAPIDS
Mailing Address - State:IA
Mailing Address - Zip Code:52404
Mailing Address - Country:US
Mailing Address - Phone:319-558-0342
Mailing Address - Fax:319-558-0343
Practice Address - Street 1:MERCY CARE OCCUPATIONAL HEALTH AT PRAIRIE CREEK
Practice Address - Street 2:777 76TH AVE DR SW, SUITE 400
Practice Address - City:CEDAR RAPIDS
Practice Address - State:IA
Practice Address - Zip Code:52404
Practice Address - Country:US
Practice Address - Phone:319-558-0342
Practice Address - Fax:319-558-0343
Is Sole Proprietor?:No
Enumeration Date:2007-06-20
Last Update Date:2022-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA400932083X0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083X0100XAllopathic & Osteopathic PhysiciansPreventive MedicineOccupational Medicine