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NPI Code Detail

MEDICARE: DR. ADAM SANFORD NIELSON MD

MEDICARE: DR. ADAM SANFORD NIELSON 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
1207P00000XEmergency Medicine PhysicianMD60130455WA
2208D00000XGeneral Practice Physician23355NE
3207P00000XEmergency Medicine Physician10104037-1205UT

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1790756815
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ADAM SANFORD NIELSON MD
Provider Business Mailing Address
First Line : 250 W 300 N
Second Line :
City : ROOSEVELT
State : UT
Zip : 84066-2351
Country : US
Telephone Number : 719-282-8710
Fax Number : 719-282-8710
Provider Business Practice Location Address
First Line : 250 W 300 N
Second Line :
City : ROOSEVELT
State : UT
Zip : 84066-2351
Country : US
Telephone Number : 435-722-4691
Fax Number : 435-722-9291
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/27/2006
Last Update Date : 01/29/2025

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Directions to “ DR. ADAM SANFORD NIELSON MD” Practice Location

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