Provider Demographics
NPI:1336211739
Name:NOLAN, SERENA ROSE (MD)
Entity Type:Individual
Prefix:DR
First Name:SERENA
Middle Name:ROSE
Last Name:NOLAN
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Gender:F
Credentials:MD
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Mailing Address - Street 1:8831 SATYR HILL RD
Mailing Address - Street 2:STE. 100
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21234-2306
Mailing Address - Country:US
Mailing Address - Phone:410-668-4300
Mailing Address - Fax:410-668-3744
Practice Address - Street 1:8831 SATYR HILL RD
Practice Address - Street 2:STE. 100
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21234-2306
Practice Address - Country:US
Practice Address - Phone:410-668-4300
Practice Address - Fax:410-668-3744
Is Sole Proprietor?:No
Enumeration Date:2006-11-14
Last Update Date:2011-06-30
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Provider Licenses
StateLicense IDTaxonomies
MDD0025010207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD329601600Medicaid
D76305Medicare UPIN