Provider Demographics
NPI:1285728667
Name:NOLAN, MARGARET J (MD)
Entity type:Individual
Prefix:
First Name:MARGARET
Middle Name:J
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 1:1505 LOS ALAMOS AVE SW
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87104-1119
Mailing Address - Country:US
Mailing Address - Phone:505-270-5490
Mailing Address - Fax:
Practice Address - Street 1:1505 LOS ALAMOS AVE SW
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87104-1119
Practice Address - Country:US
Practice Address - Phone:505-270-5490
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-03
Last Update Date:2023-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM96331207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM14480Medicaid
NMNM301323Medicare PIN
$$$$$$$$$PMedicare PIN
NM14480Medicaid