Healthcare Provider Details

I. General information

NPI: 1730221466
Provider Name (Legal Business Name): NILS E FOLEY M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/12/2007
Last Update Date: 04/03/2025
Certification Date: 04/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

182 SEA ISLAND PKWY
LADYS ISLAND SC
29907-1503
US

IV. Provider business mailing address

1 N BROADWAY BLDG A SUITE 100
DENVER CO
80203-3959
US

V. Phone/Fax

Practice location:
  • Phone: 843-322-1933
  • Fax: 843-322-1912
Mailing address:
  • Phone: 303-455-6345
  • Fax: 303-455-6343

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number84815
License Number StateSC
# 2
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number20022-00156
License Number StateNC
# 3
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License NumberMED-PHYS-LIC-43720
License Number StateMT
# 4
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License NumberDR0042357
License Number StateCO

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: