MEDICARE: DR. BENJAMIN ADAM 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
1	2080P0214X	Pediatric Pulmonology Physician	230900	MA

General Provider Information

NPI Number	:	1992831721
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BENJAMIN ADAM NELSON MD

Provider Business Mailing Address
First Line	:	55 LAKE AVE N
Second Line	:
City	:	WORCESTER
State	:	MA
Zip	:	01655-0002
Country	:	US
Telephone Number	:	774-441-8086
Fax Number	:	774-441-8071

Provider Business Practice Location Address
First Line	:	55 LAKE AVE N
Second Line	:
City	:	WORCESTER
State	:	MA
Zip	:	01655-0002
Country	:	US
Telephone Number	:	774-441-8086
Fax Number	:	774-441-8071

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

Provider Enumeration Date	:	02/26/2007
Last Update Date	:	01/30/2026

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