Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Dr. Michael David Nickerson Jr., MD

Individual provider Anesthesiology Physician · NPI 1790927671

Dr. Michael David Nickerson Jr., MD is an Anesthesiology in Fort Liberty, North Carolina. Qualified in 2008, 18 years ago. Practices with Medstream Anesthesia PLLC, a 577-clinician group and accepts Medicare assignment. Licensed in North Carolina, Texas and Virginia.

Years since qualifying
18
Licensed in
NC, TX, VA
In the registry since
2009
Specialties on file
3
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

See every abbreviation used in this directory →

Practice location Address checks out

2817 Rock Merritt Ave Stop A
Fort Liberty, NC 28310-7394
Phone: (910) 908-2318
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Anesthesiology Physician (primary) Taxonomy 207L00000X · Licence 2019-02595 (NC)
Anesthesiology Physician Taxonomy 207L00000X · Licence Q4227 (TX)
Anesthesiology Physician Taxonomy 207L00000X · Licence 0101246915 (VA)

Record details

NPI number1790927671
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorYes
NPI enumeratedMarch 24, 2009
Last updated in NPPESJanuary 1, 2025
Certification dateJanuary 1, 2025

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyANESTHESIOLOGY
Medical schoolOTHER
Graduated 2008 (18 years in practice)
Group practice Medstream Anesthesia Pllc — 577 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount