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NPI Code Detail

MEDICARE: DR. RAYMOND P. NOLAN M.D.

MEDICARE: DR. RAYMOND P. NOLAN M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207R00000XInternal Medicine PhysicianMD10560OR

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1275538910
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. RAYMOND P. NOLAN M.D.
Provider Business Mailing Address
First Line : 2700 SE STRATUS AVE
Second Line :
City : MCMINNVILLE
State : OR
Zip : 97128-6255
Country : US
Telephone Number : 503-435-6441
Fax Number : 503-435-6445
Provider Business Practice Location Address
First Line : 2700 SE STRATUS AVE
Second Line :
City : MCMINNVILLE
State : OR
Zip : 97128-6255
Country : US
Telephone Number : 503-435-6441
Fax Number : 503-435-6445
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/17/2005
Last Update Date : 07/17/2007

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