Provider Demographics
NPI:1780684282
Name:COLOVOS, NICK EDWARD (MD)
Entity Type:Individual
Prefix:DR
First Name:NICK
Middle Name:EDWARD
Last Name:COLOVOS
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Gender:M
Credentials:MD
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Mailing Address - Street 1:1 COCA COLA PLZ NW
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30313-2420
Mailing Address - Country:US
Mailing Address - Phone:404-778-7777
Mailing Address - Fax:404-515-4023
Practice Address - Street 1:1 COCA COLA PLZ NW
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30313-2420
Practice Address - Country:US
Practice Address - Phone:404-778-7777
Practice Address - Fax:404-515-4023
Is Sole Proprietor?:No
Enumeration Date:2005-07-26
Last Update Date:2015-12-02
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Provider Licenses
StateLicense IDTaxonomies
GA72520207P00000X, 207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAG36235Medicare UPIN