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Individual

DR. MARK HARVEY NELSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
750 HIGHLAND OAKS DR STE 100, WINSTON SALEM, NC 27103-7110
(336) 659-1528
(336) 659-1980
Mailing address
MEDICAL CENTER BLVD., WINSTON SALEM, NC 27157-0001
(336) 716-1332

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
33109
NC
207WX0107X
Retina Specialist (Ophthalmology) Physician
Primary
33109
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
10053
OPTICARE
NC
01
4557306002
CIGNA
NC
01
62094
BCBS
NC
01
698
PARTNERS
NC
05
8962094
NC
Enumeration date
06/22/2005
Last updated
02/26/2019
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