NPI 1063498673

Pamela Jean Niksich, MD

Practitioner Pediatrics Physician Maple Grove, MN

Practice location

Address: 12720 Bass Lake Rd, Maple Grove, MN 55369-6307
Phone: (763) 559-2861
Fax: (763) 559-1338

Registered specialties

Pediatrics Physician Primary

Allopathic & Osteopathic Physicians Taxonomy 208000000X Licence 45836 (MN)

Other Pediatrics providers in Minnesota →

Registry record

NPI: 1063498673
Entity type: Individual
Sex (as registered): Female
NPI issued: 16 Dec 2005
Record last updated: 9 Jun 2016

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.