Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Mr. Douglas Arthur Pacholke III, RN

Individual provider Registered Nurse · NPI 1902510621

Mr. Douglas Arthur Pacholke III, RN is a Certified Registered Nurse Anesthetist (CRNA) in Detroit, Michigan. Qualified in 2024, 2 years ago. Practices with Northstar Anesthesia of Michigan III PLLC, a 567-clinician group. Licensed in Michigan.

Years since qualifying
2
Licensed in
MI
In the registry since
2023
What do these letters mean?
RN — Registered Nurse
A licensed nurse who completed a nursing degree and passed the NCLEX-RN examination.

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Practice location Address checks out

4001 W McNichols Rd
Detroit, MI 48221-3038
Phone: (313) 993-1245
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Registered Nurse (primary) Taxonomy 163W00000X · Licence 4704340987 (MI)

Record details

NPI number1902510621
Entity typeIndividual (Type 1)
GenderMale
Credentials RN
Sole proprietorYes
NPI enumeratedJanuary 9, 2023
Last updated in NPPESJanuary 9, 2023
Certification dateJanuary 7, 2023

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyCERTIFIED REGISTERED NURSE ANESTHETIST (CRNA)
Medical schoolOTHER
Graduated 2024 (2 years in practice)
Group practice Northstar Anesthesia Of Michigan Iii Pllc — 567 clinicians
Accepts Medicare assignment Not indicated
Practice locations2 on file with Medicare

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