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General NPI Number Information
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NPI Number | 1780979658
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Entity Type | Individual
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Provider Name | SPENCER NADOLSKY DO
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Gender | Male
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Dates
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Enumeration Date | 06/17/2011
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Last Update Date | 01/13/2025
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Provider Practice Location Address
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Address Line | 430 E 8TH ST # 5134
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City | HOLLAND
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State | MI
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Zip | 49423-3751
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Country | US
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Telephone | 415-625-1768
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Fax | 855-259-7555
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Provider Business Mailing Address
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Address Line | 430 E 8TH ST # 5134
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City | HOLLAND
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State | MI
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Zip | 49423-3751
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Country | US
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Telephone | 415-625-1768
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Fax | 855-259-7555
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207QB0002X
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Taxonomy Name | Obesity Medicine (Family Medicine) Physician
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License Number | H0079510
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License Number State | MD
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 0116023930
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License Number State | VA
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