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General NPI Number Information
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NPI Number | 1881743664
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Entity Type | Individual
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Provider Name | NATHANIEL JONATHAN NELMS M.D.
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Gender | Male
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Dates
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Enumeration Date | 01/09/2007
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Last Update Date | 05/28/2015
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Provider Practice Location Address
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Address Line | 192 TILLEY DR
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City | SOUTH BURLINGTON
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State | VT
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Zip | 05403-4440
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Country | US
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Telephone | 802-847-0000
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Fax |
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Provider Business Mailing Address
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Address Line | 192 TILLEY DR
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City | SOUTH BURLINGTON
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State | VT
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Zip | 05403-4440
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Country | US
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Telephone | 802-847-0000
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Fax |
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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 | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | EF4323200BF
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License Number State | VT
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Taxonomy #2
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | 105636
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License Number State | MN
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Taxonomy #3
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | 54532
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License Number State | MN
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