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NPI Code Detail

MEDICARE: DR. STEPHEN J NELSON M.D.

MEDICARE: DR. STEPHEN J NELSON M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207XS0114XAdult Reconstructive Orthopaedic Surgery Physician63627CT
2207X00000XOrthopaedic Surgery Physician63627CT

General Provider Information

NPI Number : 1194161604
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. STEPHEN J NELSON M.D.
Provider Business Mailing Address
First Line : 2 BARNES INDUSTRIAL RD S
Second Line :
City : WALLINGFORD
State : CT
Zip : 06492-2486
Country : US
Telephone Number : 203-626-0160
Fax Number : 203-294-6734
Provider Business Practice Location Address
First Line : 258 BROAD ST
Second Line :
City : MILFORD
State : CT
Zip : 06460-3226
Country : US
Telephone Number : 203-882-3373
Fax Number : 203-882-3372
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/12/2013
Last Update Date : 05/12/2026

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