Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RE0101X | Endocrinologist (Diabetes Doctor) | 0102202594 | VA |
Y | 207RE0101X | Endocrinologist (Diabetes Doctor) | 5101023031 | MI |
NPI | 1053567743 |
---|---|
Provider Name | Dr. Karl Nadolsky JR. |
First Address | Grand Rapids, MI 49503-2560 |
Second Address | Grand Rapids, MI 49503-2533 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/08/2008 |
Last Update Date | 24/02/2021 |