Provider Demographics
NPI:1700842622
Name:NATOLE, JOSEPH (MD)
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:
Last Name:NATOLE
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 1:4701 TOWNE CENTRE RD STE 103
Mailing Address - Street 2:
Mailing Address - City:SAGINAW
Mailing Address - State:MI
Mailing Address - Zip Code:48604-2800
Mailing Address - Country:US
Mailing Address - Phone:989-759-9142
Mailing Address - Fax:989-759-9123
Practice Address - Street 1:4701 TOWNE CENTRE RD STE 103
Practice Address - Street 2:
Practice Address - City:SAGINAW
Practice Address - State:MI
Practice Address - Zip Code:48604-2800
Practice Address - Country:US
Practice Address - Phone:989-759-9142
Practice Address - Fax:989-759-9123
Is Sole Proprietor?:No
Enumeration Date:2006-04-21
Last Update Date:2023-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301050537207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0730847OtherBLUE CROSS/BLUE SHIELD
MI2581408Medicaid
MIJN050537OtherMI LICENSE
MI0730847OtherBLUE CROSS/BLUE SHIELD
MI0730847Medicare ID - Type Unspecified