Provider Demographics
NPI:1558325787
Name:HOWARD, NATHANIEL JR (MD)
Entity Type:Individual
Prefix:
First Name:NATHANIEL
Middle Name:
Last Name:HOWARD
Suffix:JR
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 1:2721 OLIVE HWY
Mailing Address - Street 2:STE 12
Mailing Address - City:OROVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95966
Mailing Address - Country:US
Mailing Address - Phone:530-533-6061
Mailing Address - Fax:530-533-4438
Practice Address - Street 1:2721 OLIVE HWY
Practice Address - Street 2:STE 12
Practice Address - City:OROVILLE
Practice Address - State:CA
Practice Address - Zip Code:95966
Practice Address - Country:US
Practice Address - Phone:530-533-6061
Practice Address - Fax:530-533-4438
Is Sole Proprietor?:No
Enumeration Date:2006-04-14
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG54153207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAGR0014101Medicaid
CAG54153OtherSTATE LICENSE
AH9561590OtherDEA
A52665Medicare UPIN
AH9561590OtherDEA