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General NPI Number Information
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NPI Number | 1053598151
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Entity Type | Organization
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Legal Business Name | BRIAN K. NADOLNE, MD, PC
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Dates
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Enumeration Date | 01/31/2008
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Last Update Date | 04/23/2008
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Provider Practice Location Address
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Address Line | 1230 JOHNSON FERRY PL STE H20
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City | MARIETTA
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State | GA
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Zip | 30068-2057
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Country | US
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Telephone | 770-509-0017
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Fax | 770-971-7818
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Provider Business Mailing Address
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Address Line | 1230 JOHNSON FERRY PL STE H20
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City | MARIETTA
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State | GA
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Zip | 30068-2057
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Country | US
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Telephone | 770-509-0017
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Fax | 770-971-7818
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. BRIAN KEITH NADOLNE
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Credential | MD
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Telephone | 770-509-0017
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 040748
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License Number State | GA
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