MEDICARE: DR. MICHAEL NELSON 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
1	207R00000X	Internal Medicine Physician	4301074754	MI
2	208M00000X	Hospitalist Physician	4301074754	MI
3	207R00000X	Internal Medicine Physician	45230	TN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	89033750	OTHER	AL	BCBS AL
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	1851396303	OTHER	MI	NPI #
4	70-0-F32947-0	OTHER	MI	BCBS CPIN #
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
6	MN074754	OTHER	MI	BCBSM

General Provider Information

NPI Number	:	1851396303
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MICHAEL NELSON M.D.

Provider Business Mailing Address
First Line	:	2711 FOSTER AVE
Second Line	:
City	:	NASHVILLE
State	:	TN
Zip	:	37210-5307
Country	:	US
Telephone Number	:	615-227-3000
Fax Number	:

Provider Business Practice Location Address
First Line	:	905 MAIN ST
Second Line	:
City	:	NASHVILLE
State	:	TN
Zip	:	37206
Country	:	US
Telephone Number	:	615-227-3000
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/20/2005
Last Update Date	:	11/04/2019

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