IndividualActive
Andrew Nicholson, MD
NPI 1063041960 · Surgery Physician · Otsego, MN
Provider details
- NPI number
- 1063041960
- Entity type
- Individual
- Primary specialty
- Surgery PhysicianAllopathic & Osteopathic Physicians
- Credential
- MD
- Sex
- Male
- Sole proprietor
- No
- License
- 79893 (MN)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Practice location
7559 Oday Ln Ne
Otsego, MN 55330-6314
Phone: (612) 214-0386
Approximate (ZIP-level) locationGet directions
Mailing address
7559 Oday Ln Ne
Otsego, MN 55330-6314
Registry dates
- Enumerated
- 2020-04-03
- Last updated
- 2026-01-13
- Certified
- 2026-01-13
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.