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1417907122
RICHARD K NICCUM
FORT WAYNE, IN
NPI
1417907122
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
207P00000X Emergency Medicine
(Licence: IN 01037769A)
Enumeration Date
2006-05-11
Last Update Date
2013-05-22
Business Address
-- RICHARD K NICCUM MD
2121 LAKE AVE
FORT WAYNE, IN 46805-5100
Phone number: 260-426-5431
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Mailing Address
-- RICHARD K NICCUM MD
3460 N STATE ROAD 109
COLUMBIA CITY, IN 46725-8953
Phone number: 260-229-1714
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