Provider Demographics
NPI:1396861241
Name:STYN, NICHOLAS R (MD)
Entity Type:Individual
Prefix:
First Name:NICHOLAS
Middle Name:R
Last Name:STYN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:5450 FRANTZ RD STE 360
Mailing Address - Street 2:
Mailing Address - City:DUBLIN
Mailing Address - State:OH
Mailing Address - Zip Code:43016-4141
Mailing Address - Country:US
Mailing Address - Phone:614-544-6155
Mailing Address - Fax:614-544-6370
Practice Address - Street 1:4343 ALL SEASONS DR STE 240
Practice Address - Street 2:
Practice Address - City:HILLIARD
Practice Address - State:OH
Practice Address - Zip Code:43026-1999
Practice Address - Country:US
Practice Address - Phone:614-544-1460
Practice Address - Fax:614-544-1853
Is Sole Proprietor?:No
Enumeration Date:2007-03-22
Last Update Date:2022-01-25
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI4301087780390200000X
OH35.126702208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program