Provider Demographics
NPI:1578563680
Name:NICHOLSON, BRITAIN WELTON (MD)
Entity Type:Individual
Prefix:DR
First Name:BRITAIN
Middle Name:WELTON
Last Name:NICHOLSON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:PO BOX 9142
Mailing Address - Street 2:
Mailing Address - City:CHARLESTOWN
Mailing Address - State:MA
Mailing Address - Zip Code:02129-9142
Mailing Address - Country:US
Mailing Address - Phone:617-724-6610
Mailing Address - Fax:617-724-6649
Practice Address - Street 1:15 PARKMAN STREET
Practice Address - Street 2:BULFINCH MEDICAL GROUP, WANG 535
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02114-2621
Practice Address - Country:US
Practice Address - Phone:617-724-6610
Practice Address - Fax:617-724-6649
Is Sole Proprietor?:No
Enumeration Date:2005-07-29
Last Update Date:2014-02-14
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MA46175207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA046175OtherTUFTS HEALTH PLAN
MA6176712Medicaid
MAJ03402OtherBCBS
MA6176712Medicaid
MAJ03402Medicare PIN