MEDICARE: DANIEL A NELSON MD

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
1	2084P0804X	Child & Adolescent Psychiatry Physician	35073703	OH

General Provider Information

NPI Number	:	1366512220
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DANIEL A NELSON MD

Provider Business Mailing Address
First Line	:	3333 BURNET AVENUE
Second Line	:	ML 6015
City	:	CINCINNATI
State	:	OH
Zip	:	45229-3026
Country	:	US
Telephone Number	:	513-636-0800
Fax Number	:	513-803-0823

Provider Business Practice Location Address
First Line	:	3333 BURNET AVENUE
Second Line	:	ML 6015
City	:	CINCINNATI
State	:	OH
Zip	:	45229-3026
Country	:	US
Telephone Number	:	513-636-0800
Fax Number	:	513-803-0823

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/08/2006
Last Update Date	:	02/26/2015

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