Provider Demographics
NPI:1639462393
Name:NOLT, CURTIS LEE (DO)
Entity type:Individual
Prefix:
First Name:CURTIS
Middle Name:LEE
Last Name:NOLT
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:33 E CHESTNUT HILL AVE
Mailing Address - Street 2:SUITE 201
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19118-2713
Mailing Address - Country:US
Mailing Address - Phone:215-247-0900
Mailing Address - Fax:215-247-7696
Practice Address - Street 1:33 E CHESTNUT HILL AVE
Practice Address - Street 2:SUITE 201
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19118-2713
Practice Address - Country:US
Practice Address - Phone:215-247-0900
Practice Address - Fax:215-247-7696
Is Sole Proprietor?:No
Enumeration Date:2011-05-26
Last Update Date:2016-08-31
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAOT014073207Q00000X
DEC2-0010953207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine