Healthcare Provider Details

I. General information

NPI: 1851626329
Provider Name (Legal Business Name): SETH LAWRENCE NOLAND M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/16/2009
Last Update Date: 01/27/2021
Certification Date: 01/27/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

115 HEART DR ECU PHYSICIANS CARDIOVASCULAR SURGERY
GREENVILLE NC
27834-8982
US

IV. Provider business mailing address

6150 E BROAD ST
COLUMBUS OH
43213-1574
US

V. Phone/Fax

Practice location:
  • Phone: 252-744-4400
  • Fax: 252-744-3987
Mailing address:
  • Phone: 614-546-4808
  • Fax: 614-546-4627

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2086S0129X
TaxonomyVascular Surgery Physician
License Number35.098903
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number2016-00429
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: