Nordstrom, Charles R
Nordstrom, Charles R is an sole proprietor health care provider with primary practice located at 127 Canterbury Rd , Eau Claire WI 54701-7105. He recently has only one registered license in Allopathic & Osteopathic Physicians / Gastroenterology, which is considered as his primary health care specialty. Nordstrom, Charles R can be contacted via phone (715) 835-1884.Contact Information
Primary practice address
127 Canterbury Rd
Eau Claire WI 54701-7105
Phone: (715) 835-1884
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Gastroenterology | 207RG0100X | 21796 | Wisconsin |
Profile Details
| NPI number | 1528031069 |
|---|---|
| LBN Legal business name | Nordstrom, Charles R |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Feb 7th, 2006 |
| Last updated | Jan 31st, 2012 - about 14 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1528031069 | NPPES |
| Wisconsin | MEDICAID | 30184300 |
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