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General NPI Number Information
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NPI Number | 1902082936
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Entity Type | Organization
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Legal Business Name | MICHAEL J NELSON MD PC
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Dates
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Enumeration Date | 01/22/2008
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Last Update Date | 07/31/2008
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Provider Practice Location Address
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Address Line | 2800 CLAY EDWARDS DR
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City | NORTH KANSAS CITY
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State | MO
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Zip | 64116-3220
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Country | US
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Telephone | 913-234-1350
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Fax | 913-234-1108
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Provider Business Mailing Address
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Address Line | PO BOX 843620
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City | KANSAS CITY
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State | MO
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Zip | 64184-3620
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Country | US
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Telephone | 913-234-1350
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Fax | 913-234-1108
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Authorized Official
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Title or Position | OWNER
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Name | MICHAEL J NELSON
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Credential | MD
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Telephone | 913-234-1350
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207PE0005X
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Taxonomy Name | Undersea and Hyperbaric Medicine (Emergency Medicine) Physician
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License Number | R8N03
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License Number State | MO
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