MEDICARE: JOSEPH EDWARD NOLAN MD

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	174400000X	Specialist	19839	SC
2	207L00000X	Anesthesiology Physician	19839	SC
3	207LP2900X	Pain Medicine (Anesthesiology) Physician	19839	SC
4	246ZG1000X	Medical Geneticist (PhD) Specialist/Technologist
5	208VP0014X	Interventional Pain Medicine Physician	19839	SC

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
3	080192298	OTHER	SC	RAILROAD MEDICARE
5	5370360001	OTHER	SC	MEDICARE DME

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	352982100	OTHER	SC	OWCP
2	753062671	OTHER	SC	COMPANION ID
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
6	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
7	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1679576813
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOSEPH EDWARD NOLAN MD

Provider Business Mailing Address
First Line	:	9267 MEDICAL PLAZA DR
Second Line	:	STE G
City	:	N CHARLESTON
State	:	SC
Zip	:	29406-9139
Country	:	US
Telephone Number	:	843-797-3636
Fax Number	:	843-797-3637

Provider Business Practice Location Address
First Line	:	9267 MEDICAL PLAZA DR
Second Line	:	STE G
City	:	N CHARLESTON
State	:	SC
Zip	:	29406-9139
Country	:	US
Telephone Number	:	843-797-3636
Fax Number	:	843-797-3637

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

Provider Enumeration Date	:	05/23/2005
Last Update Date	:	08/05/2025

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Directions to “ JOSEPH EDWARD NOLAN MD” Practice Location

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