# RYAN JAMES NELSON

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1194955831
- **Gender:** Man
- **Credential:** DO

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208600000X | Surgery Physician | 5101018425 | MI | — |
| 208800000X | Urology Physician | 5101018424 | MI | Yes |

## Other

- **Enumeration date:** 07/15/2009
- **Last updated:** 04/28/2021

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 0E06273 | BCBSM | MI |