Individual
MICHAEL R NORDSTROM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4600 W LOOMIS RD, SUITE 201, GREENFIELD, WI 53220-4858
(414) 281-4466
(414) 281-4528
Mailing address
PO BOX 735044, CHICAGO, IL 60673-5044
(800) 326-2250
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
33304
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
31810600
—
WI
Enumeration date
08/10/2006
Last updated
07/01/2024
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