Individual
PETER S NOLAN
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1230 E MAIN STREET, MANKATO CLINIC @ MAIN STREET, MANKATO, MN 56002-8674
(507) 625-1811
Mailing address
1230 E MAIN ST, PO BOX 8674 MANKATO CLINIC LTD, MANKATO, MN 56002-8674
(507) 625-1811
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
23067
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
112538
UCARE
MN
01
—
1202178
MEDICA
MN
01
—
41084933956001C050
CHAMPUS
—
01
—
41485NO
BCBS
MN
01
—
895687
AMERICAS PPO
MN
05
—
938241
—
IA
01
—
HP25857
HEALTH PARTNERS
MN
01
—
NA2951023848
PREFERRED ONE
MN
Enumeration date
01/10/2006
Last updated
07/08/2007
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