Koludrovich, Donald Robert

Koludrovich, Donald Robert is an individual health care provider with primary practice located at 200 N Madison St , Marshall MI 49068-1143. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered, which is considered as his primary health care specialty. Koludrovich, Donald Robert can be contacted via phone (269) 781-4271.

Contact Information

Primary practice address
200 N Madison St Marshall MI 49068-1143
Phone: (269) 781-4271
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered 367500000X 4704220211 Michigan

Profile Details

NPI number 1639105612
LBN Legal business name Koludrovich, Donald Robert
Credentials Certified Registered Nurse Anesthetist (CRNA)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 23rd, 2006
Last updated Dec 5th, 2014 - about 11 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1639105612 NPPES
Michigan MEDICAID 432076010

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