Provider Demographics
NPI:1548387764
Name:FIDELMAN, NICHOLAS (MD)
Entity Type:Individual
Prefix:DR
First Name:NICHOLAS
Middle Name:
Last Name:FIDELMAN
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:505 PARNASSUS AVENUE, BOX 0628
Mailing Address - Street 2:UCSF DEPARTMENT OF RADIOLOGY
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94143
Mailing Address - Country:US
Mailing Address - Phone:415-353-1000
Mailing Address - Fax:415-476-0616
Practice Address - Street 1:505 PARNASSUS AVENUE, BOX 0628
Practice Address - Street 2:UCSF DEPARTMENT OF RADIOLOGY
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94143
Practice Address - Country:US
Practice Address - Phone:415-353-1000
Practice Address - Fax:415-476-0616
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-23
Last Update Date:2012-09-14
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAA847892085R0202X, 2085R0204X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0204XAllopathic & Osteopathic PhysiciansRadiologyVascular & Interventional Radiology
No2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology