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Individual

JOHN DANIEL NELSON

Active
Sole proprietor

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
401 PHALEN BLVD, MAIL STOP 41102E, ST PAUL, MN 55101-5302
(651) 254-7500
(651) 254-7557
Mailing address
8100 34TH AVE S, BLOOMINGTON, MN 55425-1672
(952) 883-5790
(952) 883-5395

Taxonomy

Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
23769
MN
207W00000X
Ophthalmology Physician
23769
WI

Other

Enumeration date
01/30/2006
Last updated
07/08/2007
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