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Organization

TRIDENT PAIN CENTER LLC

Active
Organization subpart
No

Provider details

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

Contact information

Practice address
9267 MEDICAL PLAZA DR STE G, N CHARLESTON, SC 29406-9139
(843) 797-3636
(843) 797-3637
Mailing address
9267 MEDICAL PLAZA DR STE G, N CHARLESTON, SC 29406-9139
(843) 797-3636
(843) 797-3637

Taxonomy

Speciality
Code
Description
License number
State
163WW0000X
Wound Care Registered Nurse
207LP2900X
Pain Medicine (Anesthesiology) Physician
2083P0011X
Undersea and Hyperbaric Medicine (Preventive Medicine) Physician
208VP0000X
Pain Medicine Physician
208VP0014X
Interventional Pain Medicine Physician
Primary
363L00000X
Nurse Practitioner

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
080192298
RAILROAD MEDICARE
SC
Enumeration date
09/16/2006
Last updated
03/02/2026
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