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General NPI Number Information
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NPI Number | 1356333645
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Entity Type | Individual
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Provider Name | PAULA M. NELSON M.D.
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Gender | Female
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Dates
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Enumeration Date | 08/22/2005
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Last Update Date | 12/23/2013
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Provider Practice Location Address
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Address Line | 629 BEAVER RUIN RD NW SUITE B
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City | LILBURN
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State | GA
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Zip | 30047-3401
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Country | US
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Telephone | 770-921-4300
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Fax | 770-381-6451
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Provider Business Mailing Address
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Address Line | 629 BEAVER RUIN RD NW SUITE B
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City | LILBURN
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State | GA
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Zip | 30047-3401
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Country | US
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Telephone | 770-921-4300
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Fax | 770-381-6451
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number | 041913
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number | 427315
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License Number State | PA
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Taxonomy #3
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Taxonomy Code | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number | 28766
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License Number State | AL
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Taxonomy #4
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Taxonomy Code | 207ND0900X
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Taxonomy Name | Dermatopathology Physician
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License Number | 041913
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License Number State | GA
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Taxonomy #5
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Taxonomy Code | 207ND0900X
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Taxonomy Name | Dermatopathology Physician
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License Number | 427315
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License Number State | PA
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Taxonomy #6
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Taxonomy Code | 207ND0900X
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Taxonomy Name | Dermatopathology Physician
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License Number | 28766
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License Number State | AL
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