Individual
GARY NELSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
5150 JOURNAL CENTER BLVD NE FL 2, ALBUQUERQUE, NM 87109-5900
(505) 232-1530
(505) 262-3380
Mailing address
PO BOX 26028, ALBUQUERQUE, NM 87125-6028
(505) 262-7963
(505) 232-1627
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
159
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
54460
—
NM
Enumeration date
07/26/2006
Last updated
10/05/2018
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