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Contact Information

EDWIN T KORNOELJE, DO
4300 CASCADE RD SE
GRAND RAPIDS, MI49546-8328
 Phone: 616-252-1500
 Fax: 616-252-1599
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Family Medicine - Sports Medicine

207QS0010X 08 Physician/Family Practice
 

Family Medicine

207Q00000X 08 Physician/Family Practice
 

Sports Medicine

2081S0010X 25 Physician/Physical Medicine and Rehabilitation
Indicates primary specialty

NPI Profile & details for EDWIN T KORNOELJE · (Male)

NPI # 1023071727
Status Active
Credentials DO (Doctor of Osteopathic)
Entity Individual
Enumeration date 04/11/2006
Last updated 12/05/2017 - About 9 years ago
Sole proprietor 1 No
Identifiers
  • MI License # 5101012620
Hospital affiliation(s)
  • METRO HEALTH HOSPITAL - (Acute Care)
    5900 BYRON CENTER AVENUE, SW
    WYOMING, MI 49519
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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