Individual
CHARLES NORDELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2845 GREENBRIER RD, #130, GREEN BAY, WI 54311-6519
(920) 288-8100
Mailing address
308 IROQUOIS AVE, GREEN BAY, WI 54301-1920
(920) 437-1177
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
22478
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
30271500W
—
WI
Enumeration date
01/09/2007
Last updated
07/31/2012
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