Provider Demographics
NPI:1457322075
Name:NOLAN, TERESA ANN (MD)
Entity Type:Individual
Prefix:
First Name:TERESA
Middle Name:ANN
Last Name:NOLAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2580 HAYMAKER RD
Mailing Address - Street 2:SUITE 106
Mailing Address - City:MONROEVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:15146-3518
Mailing Address - Country:US
Mailing Address - Phone:412-374-1441
Mailing Address - Fax:412-374-1443
Practice Address - Street 1:2580 HAYMAKER RD
Practice Address - Street 2:SUITE 106
Practice Address - City:MONROEVILLE
Practice Address - State:PA
Practice Address - Zip Code:15146-3518
Practice Address - Country:US
Practice Address - Phone:412-374-1441
Practice Address - Fax:412-374-1443
Is Sole Proprietor?:No
Enumeration Date:2006-01-31
Last Update Date:2007-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD021256E207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA094895Medicare ID - Type Unspecified
PAB76592Medicare UPIN