Individual
DR. KEISHA J NELSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
555 BARCLAY CIR STE 150, ROCHESTER HILLS, MI 48307-4587
(248) 299-5777
(248) 299-6917
Mailing address
26901 BEAUMONT BLVD STE 3D, SOUTHFIELD, MI 48033-3849
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
4301075845
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0N84060
MEDICARE
—
Enumeration date
11/23/2005
Last updated
10/20/2020
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