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NPI Code Detail

MEDICARE: DR. ERIK CHRISTIAN NILSSEN M.D.

MEDICARE: DR. ERIK CHRISTIAN NILSSEN M.D.
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
1207X00000XOrthopaedic Surgery Physician12345678AL
2207X00000XOrthopaedic Surgery PhysicianME99816FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
105120OTHERFLBLUE CROSS BLUE SHIELD
2592-05518OTHERALBLUE CROSS BLUE SHIELD

General Provider Information

NPI Number : 1457579435
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ERIK CHRISTIAN NILSSEN M.D.
Provider Business Mailing Address
First Line : 1040 GULF BREEZE PKWY
Second Line : SUITE 200
City : GULF BREEZE
State : FL
Zip : 32561-7809
Country : US
Telephone Number : 850-916-3700
Fax Number : 850-916-3710
Provider Business Practice Location Address
First Line : 825 E BURGESS RD
Second Line :
City : PENSACOLA
State : FL
Zip : 32504-7001
Country : US
Telephone Number : 850-435-4800
Fax Number : 850-916-3710
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/23/2007
Last Update Date : 01/18/2017

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