Provider Demographics
NPI:1164436671
Name:NOLIN, JAMES BARRY (MD)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:BARRY
Last Name:NOLIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1805 WILD DR
Mailing Address - Street 2:
Mailing Address - City:RICHLAND
Mailing Address - State:MI
Mailing Address - Zip Code:49083-9361
Mailing Address - Country:US
Mailing Address - Phone:269-203-6192
Mailing Address - Fax:
Practice Address - Street 1:1805 WILD DR
Practice Address - Street 2:
Practice Address - City:RICHLAND
Practice Address - State:MI
Practice Address - Zip Code:49083-9361
Practice Address - Country:US
Practice Address - Phone:269-203-6192
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-28
Last Update Date:2016-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301046133207PE0004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207PE0004XAllopathic & Osteopathic PhysiciansEmergency MedicineEmergency Medical Services
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIW17160002Medicare ID - Type Unspecified