Provider Demographics
NPI:1477608081
Name:NOSLER, MICHAEL J (MD)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:J
Last Name:NOSLER
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 1:1025 GARFIELD ST
Mailing Address - Street 2:SUITE B
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80524-3930
Mailing Address - Country:US
Mailing Address - Phone:970-495-7420
Mailing Address - Fax:970-495-7609
Practice Address - Street 1:1025 GARFIELD ST
Practice Address - Street 2:SUITE B
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80524-3930
Practice Address - Country:US
Practice Address - Phone:970-495-7420
Practice Address - Fax:970-495-7609
Is Sole Proprietor?:No
Enumeration Date:2007-01-24
Last Update Date:2016-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO45373207RG0100X
FLME109025207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL003508300Medicaid
CO40926095Medicaid
CO40926095Medicaid
FL003508300Medicaid
FLFA218ZMedicare PIN
COCOA107814Medicare PIN