Healthcare Provider Details

I. General information

NPI: 1427264373
Provider Name (Legal Business Name): NATHANIEL JAMES VOSHEL D.P.M.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/15/2007
Last Update Date: 07/22/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

721 3 MILE RD NW SUITE 100
GRAND RAPIDS MI
49544-8229
US

IV. Provider business mailing address

721 3 MILE RD NW SUITE 100
GRAND RAPIDS MI
49544-8229
US

V. Phone/Fax

Practice location:
  • Phone: 616-784-1595
  • Fax:
Mailing address:
  • Phone: 616-784-1595
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License NumberUNKNOWN
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: