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NPI Code Detail

MEDICARE: DAVID NELSON MD

MEDICARE: DAVID NELSON MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207PP0204XPediatric Emergency Medicine (Emergency Medicine) Physician63616CT
2207PP0204XPediatric Emergency Medicine (Emergency Medicine) Physician042.0014336VT

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1174663066
Entity Type Code : Individual
Provider Name (Legal Business Name) : DAVID NELSON MD
Provider Business Mailing Address
First Line : 1800 W CHARLESTON BLVD
Second Line :
City : LAS VEGAS
State : NV
Zip : 89102-2329
Country : US
Telephone Number : 702-383-3736
Fax Number :
Provider Business Practice Location Address
First Line : 111 COLCHESTER AVE
Second Line :
City : BURLINGTON
State : VT
Zip : 05401-1473
Country : US
Telephone Number : 802-847-1237
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/08/2007
Last Update Date : 02/11/2025

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