MEDICARE: JOHN ROBERT NORDIN MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	DR.0027990	CO
2	207Q00000X	Family Medicine Physician	2010-01265	NC

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	P00120862	OTHER		MEDICARE RAILROAD

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1700827706
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOHN ROBERT NORDIN MD

Provider Business Mailing Address
First Line	:	PO BOX 187
Second Line	:
City	:	FAISON
State	:	NC
Zip	:	28341-0187
Country	:	US
Telephone Number	:	910-267-2042
Fax Number	:	855-996-9090

Provider Business Practice Location Address
First Line	:	4007 M L KING JR BLVD
Second Line	:
City	:	NEW BERN
State	:	NC
Zip	:	28562-2243
Country	:	US
Telephone Number	:	252-772-9995
Fax Number	:	252-221-3939

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/09/2006
Last Update Date	:	07/12/2024

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Directions to “ JOHN ROBERT NORDIN MD” Practice Location

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