Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207N00000X | Dermatologist | 35049276 | OH |
NPI | 1053377978 |
---|---|
Provider Name | Dr. James J Nordlund |
First Address | Cincinnati, OH 45212-2298 |
Second Address | Mason, OH 45040-3706 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/04/2006 |
Last Update Date | 06/02/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0551086 | (05) | OH |
A15437 | (02) |