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

Samuel John Nystrom

Individual provider Family Medicine Physician · NPI 1760235600

Samuel John Nystrom is a Family Medicine Physician in Fruitport, Michigan. Licensed in Michigan. Registered with an NPI since 2024.

Licensed in
MI
In the registry since
2024
Specialties on file
2

Practice location Address checks out

3443 Farr Rd
Fruitport, MI 49415-8779
Phone: (231) 672-2900
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X · Licence 5151016783 (MI)
Family Medicine Physician Taxonomy 207Q00000X · Licence 5315248864 (MI)

Record details

NPI number1760235600
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedApril 10, 2024
Last updated in NPPESApril 14, 2024
Certification dateApril 14, 2024
Mailing address1675 Leahy St Ste 315, Muskegon, MI 49442-5543

Other providers in Fruitport