Provider Demographics
NPI:1871026617
Name:STILES, NICHOLAS (DO)
Entity Type:Individual
Prefix:
First Name:NICHOLAS
Middle Name:
Last Name:STILES
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1146 SOUTH CEDAR CREST BLVD.
Mailing Address - Street 2:STE 200
Mailing Address - City:ALLENTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18103-7938
Mailing Address - Country:US
Mailing Address - Phone:610-366-9000
Mailing Address - Fax:610-366-9229
Practice Address - Street 1:1146 SOUTH CEDAR CREST BLVD.
Practice Address - Street 2:STE 200
Practice Address - City:ALLENTOWN
Practice Address - State:PA
Practice Address - Zip Code:18103-7938
Practice Address - Country:US
Practice Address - Phone:610-366-9000
Practice Address - Fax:610-366-9229
Is Sole Proprietor?:No
Enumeration Date:2017-04-08
Last Update Date:2024-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA05021698207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1033214330002Medicaid