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Individual

JAMES NELSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DPM

Contact information

Practice address
4845 DIVISION AVE S, WYOMING, MI 49548-4498
(616) 531-3059
Mailing address
1773 WOODSIDE TRL NW, GRAND RAPIDS, MI 49504-2580
(616) 453-1835
(616) 453-1725

Taxonomy

Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
5901001738
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
3071580
MI
Enumeration date
08/22/2006
Last updated
11/21/2007
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