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Organization

TRIDENT PAIN CENTER, PA

Active
Organization subpart
No

Provider details

NPI number
Authorized official
JOSEPH EDWARD NOLAN MD (MEDICAL DIRECTOR)
(843) 797-3636
Entity
Organization

Contact information

Practice address
1341 OLD GEORGETOWN RD, MT PLEASANT, SC 29464-7307
(843) 797-3636
(843) 797-3637
Mailing address
9267 MEDICAL PLAZA DR STE G, CHARLESTON, SC 29406-9139
(843) 797-3636
(843) 797-3637

Taxonomy

Speciality
Code
Description
License number
State
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
GP3479
SC
Enumeration date
10/17/2014
Last updated
10/17/2014
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