Individual
MR. NOLAN MICHAEL NADZAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
1995 E STATE ST, SALEM, OH 44460-2423
(330) 759-9350
(330) 759-9387
Mailing address
3622 BELMONT AVE, 1, YOUNGSTOWN, OH 44505-1450
(330) 759-9350
(330) 759-9387
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN-288403
OH
367500000X
Certified Registered Nurse Anesthetist
Primary
COA.11389-NA
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12102006
CAQH
OH
05
—
3037921
—
OH
Enumeration date
04/05/2010
Last updated
03/17/2011
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