Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223D0004X | Dentist Anesthesiologist | 2901600916 | MI |
N | 1223G0001X | General Practice | 61669 | CA |
N | 213EG0000X | General Practice | 61669 | CA |
NPI | 1427305580 |
---|---|
Provider Name | Dr. Chad Barrett Nosek |
First Address | Grand Rapids, MI 49546-3682 |
Second Address | Highland, CA 92346-4443 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/08/2012 |
Last Update Date | 19/05/2021 |