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Individual

DAVID D. NELSEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Taxonomy

Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
54912-20
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1417184169
BCBSWI
WI
05
1417184169
WI
01
K400372132-000054176
WI MEDICARE
WI
01
NELSEDAV
MERCYCARE INSURANCE
WI
Enumeration date
06/19/2009
Last updated
09/12/2018
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