Individual
DR. JOEL ERIK NYSTROM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
225 EDGEWOOD DRIVE EXT, TRANSFER, PA 16154-1817
(724) 962-3553
(724) 962-3630
Mailing address
139 DONATION RD, GREENVILLE, PA 16125-7601
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD 018376E
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
MD018376E
STATE LICENSE
PA
Enumeration date
04/26/2006
Last updated
01/11/2023
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