Provider Demographics
NPI:1841482098
Name:VIENS, NICHOLAS A (MD)
Entity type:Individual
Prefix:DR
First Name:NICHOLAS
Middle Name:A
Last Name:VIENS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:120 WILLIAM PENN PLZ
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27704-2150
Mailing Address - Country:US
Mailing Address - Phone:919-220-5255
Mailing Address - Fax:919-313-1276
Practice Address - Street 1:120 WILLIAM PENN PLZ
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27704-2150
Practice Address - Country:US
Practice Address - Phone:919-220-5255
Practice Address - Fax:919-313-1276
Is Sole Proprietor?:No
Enumeration Date:2007-08-13
Last Update Date:2014-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC141511207X00000X
CO50897207X00000X
KY46328207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY0169Medicare PIN