Individual
DR. FRED C. NELSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.C., C.C.S.P.
Contact information
Practice address
10405 LIGON MILL RD STE F, WAKE FOREST, NC 27587-5013
(919) 556-2014
(919) 556-0996
Mailing address
10405 LIGON MILL RD STE F, WAKE FOREST, NC 27587-5013
(919) 556-2014
(919) 556-0996
Taxonomy
Speciality
Code
Description
License number
State
111NS0005X
Sports Physician Chiropractor
Primary
1075
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
08664
BLUE CROSS BLUE SHIELD NC
NC
01
—
2343112
AETNA/HMO
NC
01
—
4455933
AETNA/NON-HMO
NC
01
—
666372
ACN
NC
05
—
8908664
—
NC
Enumeration date
07/07/2006
Last updated
07/08/2007
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