Provider Demographics
NPI:1780979658
Name:NADOLSKY, SPENCER (DO)
Entity type:Individual
Prefix:DR
First Name:SPENCER
Middle Name:
Last Name:NADOLSKY
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:430 E 8TH ST # 5134
Mailing Address - Street 2:
Mailing Address - City:HOLLAND
Mailing Address - State:MI
Mailing Address - Zip Code:49423-3751
Mailing Address - Country:US
Mailing Address - Phone:415-625-1768
Mailing Address - Fax:855-259-7555
Practice Address - Street 1:430 E 8TH ST # 5134
Practice Address - Street 2:
Practice Address - City:HOLLAND
Practice Address - State:MI
Practice Address - Zip Code:49423-3751
Practice Address - Country:US
Practice Address - Phone:415-625-1768
Practice Address - Fax:855-259-7555
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-17
Last Update Date:2025-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDH0079510207QB0002X
VA0116023930207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QB0002XAllopathic & Osteopathic PhysiciansFamily MedicineObesity Medicine
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine