Individual
DR. JOHN JEFFREY NELSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
11 MAIN ST UNIT 11-205, MYSTIC, CT 06355-3654
(860) 421-1090
(860) 421-1091
Mailing address
11 MAIN ST UNIT 11-205, MYSTIC, CT 06355-3654
(860) 421-1090
(860) 421-1091
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
034771
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001347716
—
CT
Enumeration date
07/07/2005
Last updated
09/11/2024
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