Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
MR. NICHOLAS JEAN BEAULIEU, M.D.
Active Sole ProprietorPreferred Provider Organization · ATLANTA, GA
Registration Details
- NPI Number
- 1679680557
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Aug 24, 2006 (19.661070926417 yrs)
- Last Updated
- Sep 29, 2022
- License
-
42176 (GA)
- Sole Proprietor
- Yes
Practice Information
- Address
-
920 PONCE DE LEON AVE NE920 PONCE DE LEON AVEATLANTA, GA, 303064212Browse GA providers · Browse ZIP 30306
- Phone
- 4048151957
- Fax
- 4048151954
- Primary Specialty
-
Preferred Provider Organization
305R00000X
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.