Healthcare Provider Details

I. General information

NPI: 1033898093
Provider Name (Legal Business Name): WADE HOWARD NOLEN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/17/2023
Last Update Date: 04/18/2025
Certification Date: 04/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4611 CAMPUS RIDGE DR
MIDLAND MI
48640-9533
US

IV. Provider business mailing address

4000 WELLNESS DRIVE MIDLAND MALL
MIDLAND MI
48670-2000
US

V. Phone/Fax

Practice location:
  • Phone: 844-832-1956
  • Fax:
Mailing address:
  • Phone: 844-832-1956
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number4351054097
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: