Provider Demographics
NPI:1083652135
Name:DAVID L. NADOLSKI MD P.C.
Entity Type:Organization
Organization Name:DAVID L. NADOLSKI MD P.C.
Other - Org Name:NUBONES OSTEOPOROSIS CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:LEONARD
Authorized Official - Last Name:NADOLSKI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:989-832-6400
Mailing Address - Street 1:5912 EASTMAN AVE
Mailing Address - Street 2:
Mailing Address - City:MIDLAND
Mailing Address - State:MI
Mailing Address - Zip Code:48640-6839
Mailing Address - Country:US
Mailing Address - Phone:989-832-6400
Mailing Address - Fax:989-832-3663
Practice Address - Street 1:5912 EASTMAN AVE
Practice Address - Street 2:
Practice Address - City:MIDLAND
Practice Address - State:MI
Practice Address - Zip Code:48640-6839
Practice Address - Country:US
Practice Address - Phone:989-832-6400
Practice Address - Fax:989-832-3663
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-02
Last Update Date:2008-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI26785261QR0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0200XAmbulatory Health Care FacilitiesClinic/CenterRadiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI110E610541OtherBLUE CARE NETWORK
01002151OtherHEALTH PLUS
MI103254131Medicaid
611920000OtherUS DOL
110125037OtherRAILROAD MEDICARE
110125037OtherRAILROAD MEDICARE
B47054Medicare UPIN
MI0P50480Medicare PIN