Individual
DR. CAROLYN D NELSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
32756 GRAND RIVER AVE, FARMINGTON, MI 48336-3133
(248) 476-3280
(248) 476-3286
Mailing address
26901 BEAUMONT BLVD STE 3D, SOUTHFIELD, MI 48033-3849
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
5101008650
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
139928
CARE CHOICES
MI
05
—
3323613
—
MI
01
—
4033266
AETNA
MI
01
—
B0411
MCARE
MI
05
—
FV4454280
—
MI
01
—
OH26459
BLUE CROSS
MI
Enumeration date
06/12/2006
Last updated
11/17/2020
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