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

Robert J Nickodem Jr., MD

Individual provider Orthopaedic Surgery Physician · NPI 1790707966

Robert J Nickodem Jr., MD is an Orthopaedic Surgery Physician in Mentor, Ohio. Licensed in Ohio. Registered with an NPI since 2006.

Licensed in
OH
In the registry since
2006
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

7060 Wayside Dr MTR1/-102
Mentor, OH 44060-6527
Phone: (440) 357-2770
Fax: (440) 354-4669
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Orthopaedic Surgery Physician (primary) Taxonomy 207X00000X · Licence 35-05-1872-N (OH)

Record details

NPI number1790707966
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedJuly 24, 2006
Last updated in NPPESFebruary 5, 2013

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