Healthcare Provider Details

I. General information

NPI: 1003848664
Provider Name (Legal Business Name): DAVID MONROE NELSON MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/06/2006
Last Update Date: 08/27/2025
Certification Date: 08/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

138 CANAL ST STE 201
POOLER GA
31322-4047
US

IV. Provider business mailing address

113 CHANCERY LN
SAVANNAH GA
31410-3198
US

V. Phone/Fax

Practice location:
  • Phone: 912-348-3833
  • Fax: 912-348-2669
Mailing address:
  • Phone: 912-897-1702
  • Fax: 912-352-4053

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207QA0401X
TaxonomyAddiction Medicine (Family Medicine) Physician
License Number31085
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code207QB0002X
TaxonomyObesity Medicine (Family Medicine) Physician
License Number31085
License Number StateGA
# 3
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number31085
License Number StateGA
# 4
Primary TaxonomyY
Taxonomy Code208VP0000X
TaxonomyPain Medicine Physician
License Number31085
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: