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

Nicholas Mildenhall, MD

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1053707042

Nicholas Mildenhall, MD is an Otolaryngology in Marietta, Georgia. Graduated from Tufts University School of Medicine in 2015, 11 years ago. Practices with Wellstar Medical Group LLC, a 3,072-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Georgia.

Years since qualifying
11
Trained at
Tufts University School of Medicine
Licensed in
GA
In the registry since
2015
Specialties on file
2
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

699 Church St NE Ste 340
Marietta, GA 30060-1131
Phone: (678) 355-1620
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 2301 Erwin Road, Durham, NC 27710 — (919) 684-8111

Specialties & licences

Otolaryngology Physician (primary) Taxonomy 207Y00000X · Licence 84505 (GA)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X

Record details

NPI number1053707042
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorYes
NPI enumeratedApril 7, 2015
Last updated in NPPESAugust 27, 2020
Certification dateAugust 27, 2020
Mailing address699 Church St Ne Ste 340, Marietta, GA 30060-1131

Medicare enrollment

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

Medicare specialtyOTOLARYNGOLOGY
Medical schoolTUFTS UNIVERSITY SCHOOL OF MEDICINE
Graduated 2015 (11 years in practice)
Group practice Wellstar Medical Group Llc — 3072 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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