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General NPI Number Information
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NPI Number | 1053494880
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Entity Type | Individual
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Provider Name | OLAV NILENDER MD
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Gender | Male
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Dates
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Enumeration Date | 10/23/2006
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Last Update Date | 01/16/2019
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Provider Practice Location Address
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Address Line | 301 YADKIN ST
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City | ALBEMARLE
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State | NC
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Zip | 28001-3441
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Country | US
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Telephone | 704-984-4480
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Fax |
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Provider Business Mailing Address
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Address Line | 3310 WINDBLUFF DR
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City | CHARLOTTE
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State | NC
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Zip | 28277-9828
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Country | US
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Telephone | 704-542-1650
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084A0401X
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Taxonomy Name | Addiction Medicine (Psychiatry & Neurology) Physician
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License Number | 18894
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | 18894
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License Number State | NC
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