Provider Demographics
NPI:1003456393
Name:NICOLAI, ANAH MARIE
Entity type:Individual
Prefix:
First Name:ANAH
Middle Name:MARIE
Last Name:NICOLAI
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:ANAH
Other - Middle Name:MARIE
Other - Last Name:SALGAT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:540 E CANFIELD ST
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48201-1928
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:745 E ROBERT AVE
Practice Address - Street 2:
Practice Address - City:HAZEL PARK
Practice Address - State:MI
Practice Address - Zip Code:48030-1871
Practice Address - Country:US
Practice Address - Phone:810-288-8910
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-01-14
Last Update Date:2025-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program