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NPI Code Detail

MEDICARE: PAUL W. NIELSEN DO

MEDICARE: PAUL W. NIELSEN DO
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
1207P00000XEmergency Medicine Physician1539WV

General Provider Information

NPI Number : 1457313025
Entity Type Code : Individual
Provider Name (Legal Business Name) : PAUL W. NIELSEN DO
Provider Business Mailing Address
First Line : 1 HOSPITAL PLZ
Second Line :
City : GRAFTON
State : WV
Zip : 26354-1283
Country : US
Telephone Number : 304-265-0400
Fax Number :
Provider Business Practice Location Address
First Line : 1 HOSPITAL PLZ
Second Line :
City : GRAFTON
State : WV
Zip : 26354-1283
Country : US
Telephone Number : 304-265-0400
Fax Number : 304-265-6443
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/06/2006
Last Update Date : 08/13/2015

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