DAVID DARWIN NICOLAOU


Address: 550 Munson Ave, Traverse City, MI 49686-3580
Phone: 2319358710

DAVID DARWIN NICOLAOU (NPI# 1184676181) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1184676181
Entity Type Individual
Full Name DAVID DARWIN NICOLAOU
Credential MD
Practice Address 550 Munson Ave
Traverse City
MI 49686-3580
Mailing Address 2971 Crescent Shores Dr
Traverse City
MI 49684-9643
Practice Telephone 2319358710
Mailing Telephone 2319331540
Enumeration Date 2006-05-17
Last Update Date 2019-01-03
Gender Code M
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 207P00000X Emergency Medicine 4301084991 MI Allopathic & Osteopathic Physicians
N 207P00000X Emergency Medicine D45394 MD Allopathic & Osteopathic Physicians

Other Provider Identifier

State Issuer Identifier Type Code
MI 104957619 05
MD 131961200 05
BCBS DN084991 01

Office Location

Street Address 550 MUNSON AVE
City TRAVERSE CITY
State MI
Zip Code 49686-3580

Providers in the same location

NPI Name Taxonomy Address Enumeration
1205839131 William H. George Internal Medicine 550 Munson Ave, Traverse City, MI 49686 2005-05-24
1265054936 Erynne Louise Russell Speech-Language Pathologist 550 Munson Ave, Traverse City, MI 49686-3580 2020-05-15
1821624545 Susan Carol Spencer Speech-Language Pathologist 550 Munson Ave, Traverse City, MI 49686-3580 2020-03-13
1346807617 Mary Priestly Physician Assistant 550 Munson Ave, Traverse City, MI 49686-3580 2019-05-22
1194380493 Kimberly A Chandler Health Educator 550 Munson Ave, Traverse City, MI 49686-3580 2019-05-02
1942770946 Caroline Kiley Physical Therapist 550 Munson Ave, Traverse City, MI 49686-3580 2018-12-03
1851861850 Grace Blankenhagen Physical Therapist 550 Munson Ave, Traverse City, MI 49686-3580 2018-12-03
1316429863 Elizabeth Marie Teklinski Counselor 550 Munson Ave, Traverse City, MI 49686-3580 2018-08-31
1326544230 Kaitlyn Troutman Nurse Practitioner 550 Munson Ave, Traverse City, MI 49686-3580 2018-04-02
1598267254 Teresa Lynn Hearne Physical Therapist 550 Munson Ave, Traverse City, MI 49686-3580 2018-03-08
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1245877208 Jessica Marie Glowacki Behavior Technician 935 Hemlock St, Traverse City, MI 49686 2019-12-09
1568011542 Joanne Kressley Technician 1693 Maylane Apt. 104, Traverse City, MI 49686 2019-09-11
1194283846 Pace North PACE Provider Organization 2325 Garfield Road N., Traverse City, MI 49686 2019-03-12
1245749225 Margaret Anne Goss Speech-Language Pathologist 1105 E. Eighth Street, Traverse City, MI 49686 2017-09-22
1467981811 Joan Joyce Shirilla Social Worker 2124 Twin Eagles Dr, Traverse City, MI 49686 2017-06-08
1770028763 Rehab and Mobility Systems, LLC Durable Medical Equipment & Medical Supplies 707 Parsons, Traverse City, MI 49686 2016-12-29
1629511316 Kaitlyn Grangood Social Worker 415 Munson Avenue, Ste 101, Traverse City, MI 49686 2016-11-29
1811441132 Jeffrey D Goodwin Counselor 430 Fair St., Traverse City, MI 49686 2016-08-04
1053779918 Thomas Osborne Counselor 2014 Phelps Rd., Traverse City, MI 49686 2016-02-08
1982079588 Marsha Lynne Dallas Counselor 2240 South Airport Road, Traverse City, MI 49686 2015-12-08
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Taxonomy Information

Taxonomy Code 207P00000X
Grouping Allopathic & Osteopathic Physicians
Classification Emergency Medicine

Taxonomy Definition

An emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury.
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: mofified source]
- Additional Resources: American Board of Emergency Medicine, 2007. http://www.abem.org/public/; American Osteopathic Board of Emergency Medicine, 2007. http://www.osteopathic.org/certification
- Board certification for Medical Doctors (MDs) is provided by the American Board of Emergency Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Emergency Medicine.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1568002004 Munson Medical Center Emergency Medicine 5085 Anna Dr Ste B&c, Traverse City, MI 49684-7475 2020-01-13
1407016652 James Hsu Emergency Medicine 5762 Galvin Rd, Traverse City, MI 49684-7966 2008-06-11
1134166473 Jurgen Gernot Runschke Emergency Medicine 880 Munson Ave Ste A, Traverse City, MI 49686-3661 2006-06-02
1154392991 Laurie Maria Hosey Emergency Medicine 4075 Copper Ridge Dr., Eci, Traverse City, MI 49684 2006-01-30
1629076294 Michael J Parker Emergency Medicine 401 Munson Ave, Traverse City, MI 49686 2005-07-08
1760864102 Karan D Mehta Emergency Medicine 1400 Medical Campus Dr, Traverse City, MI 49684-7823 2015-06-22
1710305958 William Ulmer Britton Iv Emergency Medicine 1105 6th St, Traverse City, MI 49684-2345 2014-04-04
1013342112 Advanced Wound Care & Hyperbaric Physicians of Traverse City, Plc Emergency Medicine 1105 6th St, Traverse City, MI 49684-2349 2013-09-08
1568800480 Laura Santoro Emergency Medicine 1400 Medical Campus Dr, Traverse City, MI 49684-7823 2013-06-13
1851671697 Traverse Observation Physician Services PC Emergency Medicine 1105 6th St, Traverse City, MI 49684-2345 2011-08-25
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Competitor

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City TRAVERSE CITY
Zip Code 49686

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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