Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
EDWIN T KORNOELJE, D.O.
ActiveEDWIN T KORNOELJE, D.O. is a Sports Medicine healthcare provider located in GRAND RAPIDS, Michigan. NPI 1023071727 is currently active in the NPPES registry. Verify at CMS.
Sports Medicine · GRAND RAPIDS, MI
Registration Details
- NPI Number
- 1023071727
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Apr 11, 2006 (20.298443038993 yrs)
- Last Updated
- Dec 5, 2017
- Licenses
-
5101012620 (MI)5101012620 (MI)5101012620 (MI)
Practice Information
- Address
-
4300 CASCADE RD SEGRAND RAPIDS, MI, 495468328Browse MI providers · Browse ZIP 49546
- Phone
- 6162521500
- Fax
- 6162521599
- Primary Specialty
-
Sports Medicine
207QS0010X
- Additional Specialty
- Sports Medicine (PM&R)
- Additional Specialty
- Sports Medicine
Other Sports Medicine Providers in GRAND RAPIDS, MI
| Name | Credential | NPI |
|---|---|---|
| DR. JASON NICHOLAS LAZOR | D.O. | 1083841845 |
| BRIAN JOSEPH HINKLEY | D.O. | 1619269222 |
| KYLE ALEXANDER | MD | 1902335912 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.