Individual provider · Type 1 NPI
Charles R. Nicolosi, MD
Specialist · Cannon Falls, MN
NPI number
1063596831
Active
Practice location
116 Mill St W.
Cannon Falls, MN 55009-2027
Mailing address
2031 32nd St S
La Crosse, WI 54601-7099
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Specialist Primary | 174400000X | 20585 (MN) |
Specialist: 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.
About NPI 1063596831
Charles R. Nicolosi, MD's National Provider Identifier is 1063596831, issued on Oct 25, 2006. The primary taxonomy on file is Specialist (174400000X), and the practice location is in Cannon Falls, MN. The record was last updated on Nov 14, 2007.