Individual
KENNETH E NELSON
Active
Individual
KENNETH E NELSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
9600657
NC
207LP2900X
Pain Medicine (Anesthesiology) Physician
9600657
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1032U
BCBS
NC
01
—
19627
PARTNERS
NC
05
—
3810001343
—
WV
01
—
5124538
AETNA
—
05
—
5716047
—
VA
01
—
72411
MEDCOST
NC
05
—
891032U
—
NC
Enumeration date
12/13/2005
Last updated
09/08/2017
Update your record
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