Provider Demographics
NPI:1912439019
Name:NICHOLS, DARRIN EARL (MD)
Entity Type:Individual
Prefix:
First Name:DARRIN
Middle Name:EARL
Last Name:NICHOLS
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 1:483 COURT ST
Mailing Address - Street 2:
Mailing Address - City:ELIZABETH
Mailing Address - State:WV
Mailing Address - Zip Code:26143-1109
Mailing Address - Country:US
Mailing Address - Phone:304-388-4600
Mailing Address - Fax:304-388-4621
Practice Address - Street 1:3200 MACCORKLE AVE SE
Practice Address - Street 2:ROBERT C. BYRD CLINICAL TEACHING CENTER, 5TH FLOOR
Practice Address - City:CHARLESTON
Practice Address - State:WV
Practice Address - Zip Code:25304-1227
Practice Address - Country:US
Practice Address - Phone:304-388-4600
Practice Address - Fax:304-388-4621
Is Sole Proprietor?:No
Enumeration Date:2017-03-29
Last Update Date:2020-10-26
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WV29648207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine