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Individual
PHILIP T NELSEN
Active
Individual
PHILIP T NELSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
35049048
OH
207WX0107X
Retina Specialist (Ophthalmology) Physician
Primary
35049048
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0517668
—
OH
01
—
1804611061
BCBS OF MICHIGAN
MI
01
—
NE0531841
MEDICARE PTAN
OH
Enumeration date
06/01/2005
Last updated
04/05/2017
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