MEDICARE: MR. NOLAN RUDOLPH MAUNEY JR. 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
1	207Q00000X	Family Medicine Physician	20045	NC

General Provider Information

NPI Number	:	1710036942
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. NOLAN RUDOLPH MAUNEY JR. M.D.

Provider Business Mailing Address
First Line	:	PO BOX 3086
Second Line	:
City	:	MORGANTON
State	:	NC
Zip	:	28680-3086
Country	:	US
Telephone Number	:	828-391-8364
Fax Number	:	828-391-1722

Provider Business Practice Location Address
First Line	:	219A AVERY AVE
Second Line	:
City	:	MORGANTON
State	:	NC
Zip	:	28655-3102
Country	:	US
Telephone Number	:	828-391-8364
Fax Number	:	828-391-1722

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/09/2007
Last Update Date	:	03/02/2017

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