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NPI 1386684017

NPI 1386684017 : RICHARD S. NELSON MD : CONCORD, NH

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General NPI Number Information
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    NPI Number           |    1386684017
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    Entity Type          |    Individual 
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    Provider Name        |    RICHARD S. NELSON MD
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    06/08/2006
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    Last Update Date     |    10/22/2018
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Provider Practice Location Address
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    Address Line         |    18 FOUNDRY ST SUITE 201
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    City                 |    CONCORD
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    State                |    NH
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    Zip                  |    03301-5421
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    Country              |    US
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    Telephone            |    603-228-0071
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    Fax                  |    603-227-7535
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Provider Business Mailing Address
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    Address Line         |    18 FOUNDRY ST SUITE 201
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    City                 |    CONCORD
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    State                |    NH
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    Zip                  |    03301-5421
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    Country              |    US
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    Telephone            |    603-228-0071
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    Fax                  |    603-227-7535
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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        |    207Q00000X
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    Taxonomy Name        |    Family Medicine Physician
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    License Number       |    9194
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    License Number State |    NH
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