Individual
CARL NELSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
111 COLCHESTER AVE, DEPT OF RADIATION ONCOLOGY, BURLINGTON, VT 05401-1473
(802) 847-3506
Mailing address
111 COLCHESTER AVE, DEPT OF RADIATION ONCOLOGY, BURLINGTON, VT 05401-1473
Taxonomy
Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
Primary
0420012686
VT
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
08/31/2009
Last updated
07/05/2013
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