Individual provider · Type 1 NPI

Edwin T. Kornoelje, DO

Sports Medicine (Family Medicine) Physician · Grand Rapids, MI

NPI number 1023071727 Active

Practice location

4300 Cascade Rd SE
Grand Rapids, MI 49546-8328

Call (616) 252-1500 Map

Fax (616) 252-1599

Mailing address

5900 Byron Center Ave SW, Medical Administration
Wyoming, MI 49519-9606

Specialties and licenses

Taxonomy	Code	License
Family Medicine Physician	207Q00000X	5101012620 (MI)
Sports Medicine (Physical Medicine & Rehabilitation) Physician	2081S0010X	5101012620 (MI)
Sports Medicine (Family Medicine) Physician Primary	207QS0010X	5101012620 (MI)

Sports Medicine (Family Medicine) Physician: A family medicine physician that is trained to be responsible for continuous care in the field of sports medicine, not only for the enhancement of health and fitness, but also for the prevention of injury and illness. A sports medicine physician must have knowledge and experience in the promotion of wellness and the prevention of injury. Knowledge about special areas of medicine such as exercise physiology, biomecha…

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About NPI 1023071727

Edwin T. Kornoelje, DO's National Provider Identifier is 1023071727, issued on Apr 11, 2006. The primary taxonomy on file is Sports Medicine (Family Medicine) Physician (207QS0010X), and the practice location is in Grand Rapids, MI. The record was last updated on Dec 5, 2017.