Nicholas Fanselow
NPI #1003675109 in Portsmouth, Virginia
Provider Information
- NPI Number
- 1003675109
- Entity Type
- Individual
- Name
- Nicholas Fanselow
- Gender
- Not Specified
- Sole Proprietor
- No
- Primary Specialty
- General Practice
- Enumeration Date
- Mar 19, 2024
- Last Updated
- Sep 26, 2025
Practice Location
- Address
- 620 JOHN PAUL JONES CIR
- City
- Portsmouth
- State
- Virginia
- ZIP Code
- 23708-2111
- Phone
- (757) 953-0669
Specialties & Taxonomy Codes
| Specialty |
|---|
| Military Health Care Provider |
| General Practice |
| Student in an Organized Health Care Education/Training Program |
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