Individual
DR. MATTHEW RYAN NELSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
6140 W CURTISIAN, STE 200, BOISE, ID 83704
(208) 302-0000
(208) 302-0055
Mailing address
3340 E GOLDSTONE WAY, MERIDIAN, ID 83642-1026
(208) 302-0000
(208) 302-0055
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
2006-01754
NC
207RC0000X
Cardiovascular Disease Physician
12422
ND
207RC0000X
Cardiovascular Disease Physician
37891
AZ
207RC0000X
Cardiovascular Disease Physician
Primary
M-13641
ID
Other
Enumeration date
11/03/2006
Last updated
04/25/2017
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