Provider Demographics
NPI:1720228661
Name:NICHOLAS A STRANEY DPM
Entity Type:Organization
Organization Name:NICHOLAS A STRANEY DPM
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE PROPIETOR
Authorized Official - Prefix:
Authorized Official - First Name:NICHOLAS
Authorized Official - Middle Name:A
Authorized Official - Last Name:STRANEY
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:843-571-3777
Mailing Address - Street 1:701 SAINT ANDREWS BLVD
Mailing Address - Street 2:
Mailing Address - City:CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29407-7140
Mailing Address - Country:US
Mailing Address - Phone:843-571-3777
Mailing Address - Fax:843-763-0285
Practice Address - Street 1:701 SAINT ANDREWS BLVD
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29407-7140
Practice Address - Country:US
Practice Address - Phone:843-571-3777
Practice Address - Fax:843-763-0285
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-03-05
Last Update Date:2009-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCPD043213ES0131X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC0363020001Medicare NSC