Healthcare Provider Details

I. General information

NPI: 1477685790
Provider Name (Legal Business Name): PATRICK H NOUD M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/12/2007
Last Update Date: 08/03/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2815 S PENNSYLVANIA AVE SUITE 204
LANSING MI
48910-3495
US

IV. Provider business mailing address

2815 S PENNSYLVANIA AVE SUITE 204
LANSING MI
48910-3495
US

V. Phone/Fax

Practice location:
  • Phone: 517-267-0200
  • Fax: 517-267-1877
Mailing address:
  • Phone: 517-267-0200
  • Fax: 517-267-1877

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number4301095240
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: