Individual
MATTHEW B. NODELMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3209 COLONIAL DR, COLUMBIA, SC 29203-6930
(803) 434-6113
(803) 758-0106
Mailing address
PO BOX 743904, ATLANTA, GA 30374-3904
(803) 296-7320
(803) 296-7330
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
35.135858
OH
207Q00000X
Family Medicine Physician
Primary
83986
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0182093
—
OH
05
—
839864
—
SC
Enumeration date
03/23/2016
Last updated
08/10/2021
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