Doctor Name: | DR. NICHOLAS M. MITTICA |
NPI Number: | 1023060696 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | M.D. |
License Number: | MD2004-0317 |
Business Practice Address: | 604 W Spring St Silver City, NM - 880614847 |
Business Phone Number: | 5753884464 |
Business Fax Number: | 5753882014 |
Mailing Address: | 604 W Spring St, SILVER CITY |
State: | NM |
Postal Code: | 880614847 |
Phone Number: | 5753884464 |
Fax Number: | 5753882014 |
NPI Enumeration Date: | 05/16/2006 |
NPI Last Update Date: | 12/10/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 174400000X |
License Number: | MD2004-0317 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NM |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Specialist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |