Individual
GEORGE MICHAEL NIDIFFER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1414 W FAIR AVE, #226, MARQUETTE, MI 49855-2675
(906) 225-3925
(906) 225-4838
Mailing address
26374 NETWORK PL, CHICAGO, IL 60673-1263
(906) 225-3630
(906) 225-4537
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
4301030113
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3108394
—
MI
Enumeration date
08/16/2005
Last updated
06/10/2013
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