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NPI Profile for NICHOLAS C DESTEFANO in FORT GORDON, GA.
A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions.
Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
General Practice |
208D00000X | 99 | Physician/Undefined Physician type[6] | |
Family Medicine |
207Q00000X | 08 | Physician/Family Practice |
| NPI # | 1154776755 |
|
| Status | Active | |
| Credentials | MD | |
| Entity | Individual | |
| Enumeration date | 05/02/2016 | |
| Last updated | 12/10/2025 - About 6 months ago | |
| Sole proprietor 1 | No | |
| Identifiers |
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|
| Hospital affiliation(s) | Not Available |
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NICHOLAS C DESTEFANO
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NICHOLAS C DESTEFANO, MD