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General NPI Number Information
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NPI Number | 1952725178
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Entity Type | Individual
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Provider Name | STEVE MICHAEL NELSON M.D. PH.D.
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Gender | Male
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Dates
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Enumeration Date | 02/07/2014
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Last Update Date | 05/23/2024
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Provider Practice Location Address
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Address Line | 965 RIDGE LAKE BLVD BLDG STE 315
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City | MEMPHIS
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State | TN
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Zip | 38120-9401
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Country | US
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Telephone | 877-348-1281
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Fax | 901-227-3206
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Provider Business Mailing Address
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Address Line | 965 RIDGE LAKE BLVD BLDG STE 315
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City | MEMPHIS
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State | TN
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Zip | 38120-9401
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Country | US
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Telephone | 877-348-1281
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Fax | 901-227-3206
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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 | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | 28908
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License Number State | NE
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Taxonomy #2
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 27444
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License Number State | MS
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Taxonomy #3
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Taxonomy Code | 2085N0700X
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Taxonomy Name | Neuroradiology Physician
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License Number | 18138
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License Number State | ND
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Taxonomy #4
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | S0343
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License Number State | TX
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