Individual
MR. NATHAN JOHN JORDAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1234 NAPIER AVE, ST JOSEPH, MI 49085
(269) 983-8300
(269) 983-6965
Mailing address
3264 N EVERGREEN DR NE, GRAND RAPIDS, MI 49525-9746
(616) 363-7339
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
4301084519
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4626133
—
MI
01
—
P00214793
RAILROAD MEDICARE
—
Enumeration date
06/21/2006
Last updated
06/15/2018
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