Individual provider · Type 1 NPI

Jake Anthony Nicholson, DO

Vascular Surgery Physician · Grand Rapids, MI

NPI number 1467013698 Active

Practice location

275 Michigan St NE
Grand Rapids, MI 49503-2531

Call (616) 267-8700 Map

Fax (616) 267-8247

Mailing address

100 Michigan St NE # MC845
Grand Rapids, MI 49503-2560

Specialties and licenses

TaxonomyCodeLicense
Vascular Surgery Physician Primary 2086S0129X5151014043 (MI)

Vascular Surgery Physician: A surgeon with expertise in the management of surgical disorders of the blood vessels, excluding the intracranial vessels or the heart.

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About NPI 1467013698

Jake Anthony Nicholson, DO's National Provider Identifier is 1467013698, issued on Jun 27, 2019. The primary taxonomy on file is Vascular Surgery Physician (2086S0129X), and the practice location is in Grand Rapids, MI. The record was last updated on Jan 27, 2025.