MEDICARE: TIMOTHY W 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
1	207L00000X	Anesthesiology Physician	16176	WV

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1457351728
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TIMOTHY W NELSON M.D.

Provider Business Mailing Address
First Line	:	PO BOX 3444
Second Line	:
City	:	CHARLESTON
State	:	WV
Zip	:	25334-3444
Country	:	US
Telephone Number	:	304-925-5486
Fax Number	:	304-925-8075

Provider Business Practice Location Address
First Line	:	501 MORRIS ST
Second Line	:
City	:	CHARLESTON
State	:	WV
Zip	:	25301-1326
Country	:	US
Telephone Number	:	304-388-6220
Fax Number	:

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

Provider Enumeration Date	:	07/28/2005
Last Update Date	:	04/03/2026

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