Individual
DR. PAUL DOUGLAS NIELSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
105 BONA VISTA LN, GALAX, VA 24333-3605
(808) 457-2570
Mailing address
105 BONA VISTA LN, GALAX, VA 24333-3605
(808) 457-2570
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
0101261500
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
013331-01
—
HI
Enumeration date
08/31/2006
Last updated
09/04/2023
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