Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
DR. NICHOLAS DEFAUW, DO
ActiveDR. NICHOLAS DEFAUW, DO is a Sports Medicine healthcare provider located in GOSHEN, Indiana. NPI 1578791398 is currently active in the NPPES registry. Verify at CMS.
Sports Medicine · GOSHEN, IN
Registration Details
- NPI Number
- 1578791398
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Jul 1, 2009 (17.077827424779 yrs)
- Last Updated
- Mar 18, 2024
- License
-
02005770A (IN)
Practice Information
- Address
-
1824 DORCHESTER CT STE AGOSHEN, IN, 46526Browse IN providers · Browse ZIP 46526
- Phone
- 5745342548
- Primary Specialty
-
Sports Medicine
207QS0010X
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.