Kornoelje, Edwin T

Kornoelje, Edwin T is an individual health care provider with primary practice located at 4300 Cascade Rd Se , Grand Rapids MI 49546-8328. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Family Medicine, Allopathic & Osteopathic Physicians / Sports Medicine. Allopathic & Osteopathic Physicians / Sports Medicine is his primary health care specialty. Kornoelje, Edwin T can be contacted via phone (616) 252-1500.

Contact Information

Primary practice address
4300 Cascade Rd Se Grand Rapids MI 49546-8328
Phone: (616) 252-1500
Fax: (616) 252-1599
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 5101012620 Michigan
Allopathic & Osteopathic Physicians / Sports Medicine 2081S0010X 5101012620 Michigan
Allopathic & Osteopathic Physicians / Sports Medicine 207QS0010X 5101012620 Michigan

Profile Details

NPI number 1023071727
LBN Legal business name Kornoelje, Edwin T
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 11th, 2006
Last updated Dec 5th, 2017 - about 8 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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