Individual provider · Type 1 NPI

Isaac James Koloditch

Student in an Organized Health Care Education/Training Program · Winston Salem, NC

NPI number 1174191399 Active

Practice location

475 Vine St
Winston Salem, NC 27101-4135

Call (941) 761-0409 Map

Mailing address

912 Madison Ave
Winston Salem, NC 27103-4542

Specialties and licenses

TaxonomyCodeLicense
Student in an Organized Health Care Education/Training Program Primary 390200000XNone listed

Student in an Organized Health Care Education/Training Program: An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

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About NPI 1174191399

Isaac James Koloditch's National Provider Identifier is 1174191399, issued on Jun 14, 2021. The primary taxonomy on file is Student in an Organized Health Care Education/Training Program (390200000X), and the practice location is in Winston Salem, NC. The record was last updated on Jun 14, 2021.