Organization
DR IVAN J NOSACEK PA
Active
Other names
Ivan J. Nosacek DPM
Organization subpart
No
Provider details
NPI number
Authorized official
IVAN JOHN NOSACEK DPM (PRESIDENT)
(301) 390-3338
Entity
Organization
Contact information
Practice address
3006 MITCHELLVILLE RD, BOWIE, MD 20716-1300
(301) 390-3338
(301) 390-7738
Mailing address
3006 MITCHELLVILLE RD, BOWIE, MD 20716-1300
(301) 390-3338
(301) 390-7738
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
00982
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
066038800
—
MD
Enumeration date
09/02/2006
Last updated
06/03/2008
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