Provider Demographics
NPI:1629056940
Name:TULOU, NICOLAS PAUL (MD)
Entity Type:Individual
Prefix:DR
First Name:NICOLAS
Middle Name:PAUL
Last Name:TULOU
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:7603 FOREST AVE
Mailing Address - Street 2:SUITE 306
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23229-4942
Mailing Address - Country:US
Mailing Address - Phone:804-282-2580
Mailing Address - Fax:804-285-4823
Practice Address - Street 1:7603 FOREST AVE
Practice Address - Street 2:SUITE 306
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23229-4942
Practice Address - Country:US
Practice Address - Phone:804-282-2580
Practice Address - Fax:804-285-4823
Is Sole Proprietor?:No
Enumeration Date:2006-01-06
Last Update Date:2010-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101029779207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
110005644Medicare ID - Type Unspecified
B59727Medicare UPIN