Individual
DR. NELSON REALO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D
Contact information
Practice address
5601 LOCH RAVEN BLVD, BALTIMORE, MD 21239-2905
(410) 751-5028
Mailing address
255 W MICHIGAN AVE, JACKSON, MI 49201-2218
(517) 787-6440
(517) 787-4146
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
D0008489
MD
Other
Enumeration date
09/21/2006
Last updated
02/18/2008
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