Individual
JOHAN FREDRIK NORDENSTAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1600 SW ARCHER RD, GAINESVILLE, FL 32610-4795
(352) 265-0169
Mailing address
PO BOX 100109, GAINESVILLE, FL 32610-0001
(352) 265-0169
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
MFC1849
FL
208C00000X
Colon & Rectal Surgery Physician
036.133844
IL
208C00000X
Colon & Rectal Surgery Physician
MFC1849
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036.133844
—
IL
Enumeration date
07/16/2010
Last updated
11/02/2021
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