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Individual
JAMES DAVID NORDSTROM
Active
Individual
JAMES DAVID NORDSTROM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
20846
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0153395
—
IA
01
—
110147576
RR MEDICARE
IA
05
—
1153395
—
IA
01
—
P01266135
RR MEDICARE
IA
Enumeration date
01/10/2006
Last updated
03/11/2014
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