Nordstrom, Leif George
Nordstrom, Leif George is an sole proprietor health care provider with primary practice located at 294 N Main St Suite 101, East Longmeadow MA 01028-1838. He recently has only one registered license in Allopathic & Osteopathic Physicians / Adolescent Medicine, which is considered as his primary health care specialty. Nordstrom, Leif George can be contacted via phone (413) 525-1870.Contact Information
Primary practice address
294 N Main St Suite 101
East Longmeadow MA 01028-1838
Phone: (413) 525-1870
Fax: (413) 525-3883
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Adolescent Medicine | 2080A0000X | 45445 | Massachusetts |
Profile Details
| NPI number | 1538147129 |
|---|---|
| LBN Legal business name | Nordstrom, Leif George |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jan 4th, 2006 |
| Last updated | Mar 5th, 2012 - about 12 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1538147129 | NPPES |
| Massachusetts | MEDICAID | 9732314 |
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