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Clarence L Nicodemus

Neuromusculoskeletal Medicine (NMM)

4660 S Hagadorn Rd Suite 500
East Lansing , Michigan 48823-5376

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Clarence L Nicodemus

Neuromusculoskeletal Medicine (NMM)

4660 S Hagadorn Rd Suite 500
East Lansing , Michigan 48823-5376

(517) 432-3928

Write a Review Save Call

Clarence L Nicodemus

Neuromusculoskeletal Medicine (NMM)

4660 S Hagadorn Rd Suite 500
East Lansing , Michigan 48823-5376

(517) 432-3928 Call

Write a Review Save

About


Features

Language(s) Spoken
English
Ethnic Identity
White / Caucasian

Specialties

  • Neuromusculoskeletal Medicine (NMM)

Languages spoken

  • English

Location

4660 S Hagadorn Rd Suite 500 East Lansing , Michigan 48823-5376

First Address

  • Clarence L Nicodemus
  • 804 Service Rd Ste A109b
  • East Lansing, MI
  • Zip : 48824-7015
  • Fax : (517) 432-3928
  • Phone : (517) 884-2976

Second Address

  • Clarence L Nicodemus
  • 4660 S Hagadorn Rd Suite 500
  • East Lansing, MI
  • Zip : 48823-5376
  • Fax : (517) 432-6150
  • Phone : (517) 432-6144

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FAQs


Where did Clarence L Nicodemus attend graduate school?

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Where did Clarence L Nicodemus do his residency?

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Where did Clarence L Nicodemus do his fellowship?

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Is Clarence L Nicodemus board certified?

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What type of doctor is Clarence L Nicodemus

Neuromusculoskeletal Medicine (NMM)

In what state does Clarence L Nicodemus practice in?

Michigan

Where is Clarence L Nicodemus ’s practice located?

4660 S Hagadorn Rd Suite 500 , East Lansing, Michigan, 48823-5376

What is Clarence L Nicodemus ’s gender?

Male

Is Clarence L Nicodemus a sole practitioner?

No

Is Clarence L Nicodemus accepting new patients?

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What languages does Clarence L Nicodemus speak?

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Does Clarence L Nicodemus accept insurance?

Yes, Clarence L Nicodemus accepts insurance

Does Clarence L Nicodemus offers telemedicine?

Clarence L Nicodemus has not indicated if he offers telemedicine

What is Clarence L Nicodemus ’s professional license number?

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What is Clarence L Nicodemus ’s NPI number?

1063690535

Does Clarence L Nicodemus have any license restrictions?

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Scope of Practice

Primary Taxonomy Code Taxonomy Specialty License Number License State
N 204D00000X Neuromusculoskeletal Medicine (NMM) 20A10296 CA
Y 204D00000X Neuromusculoskeletal Medicine (NMM) 5101016107 MI

National Provider Identifier

NPI 1063690535
Provider Name Clarence L Nicodemus
First Address East Lansing, MI 48824-7015
Second Address East Lansing, MI 48823-5376
Gender M
NPI Entity type Individual
Is Sole Proprietor No
Is Organization Subpart N/A
Enumeration Date 06/02/2008
Last Update Date 07/06/2021

Additional Identifiers

IDENTIFIER TYPE / CODE IDENTIFIER STATE
1063690535 (05) MI

NPI Footnotes


What is the National Provider Identifier (NPI)

The NPI is 10-position all-numeric identification number assigned by the NPPES to uniquely identify a health care provider.

Provider Location Address

The location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.

Provider Mailing Address

The mailing address of the provider being identified. This address may contain the same information as the provider location address.

Entity Type Code

The code describing the type of health care provider that is being assigned an NPI. The entity type codes are:
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)

What is a Subpart?

Subparts are the components and separate physical locations of organization health care providers. Subpart examples include: Hospital components include outpatient departments, surgical centers, psychiatric units, and laboratories. These components are often separately licensed or certified by States and may exist at physical locations other than that of the hospital of which they are a component.

Provider Other Organization Name

The other organization name is the alternative last name by which the provider is or has been known (if an individual) or other name by which the organization provider is or has been known. The code identifying the type of other name. The provider other organization name codes are:
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.

Provider Enumeration Date

The date the provider was assigned a unique identifier (assigned an NPI)

Last Update Date

The date that a NPI record was last updated or changed

Primary Taxonomy Code

The primary taxonomy code defines the provider type, classification, and specialization. There could be only one primary taxonomy code per NPI record. For individual NPls the license data is associated to the taxonomy code.

Authorized Official Name

The name of the person authorized to submit the PI application or to officially change data for a health care provider.

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