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Individual
MICHAEL K NEILSON
Active
Individual
MICHAEL K NEILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
11680858-1204
UT
207QS0010X
Sports Medicine (Family Medicine) Physician
Primary
11680858-1204
UT
Other
Enumeration date
04/03/2017
Last updated
07/27/2020
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