Individual
NELSON ERIC GENCHEFF
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
1414 WEST FAIR AVENUE, SUITE 334, MARQUETTE, MI 49855
(906) 225-3870
(906) 225-4861
Mailing address
1414 WEST FAIR AVENUE, SUITE 334, MARQUETTE, MI 49855
(906) 225-3870
(906) 225-4861
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
5101009341
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
060029051
RAILROAD MEDICARE
—
01
—
0655200055
BLUE CROSS BLUE SHIELD
MI
05
—
30054000
—
WI
05
—
3090816
—
MI
Enumeration date
06/16/2006
Last updated
08/22/2013
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