Individual
IAN R NEILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
2086S0120X
Pediatric Surgery Physician
5423
AK
2086S0120X
Pediatric Surgery Physician
Primary
MD18028
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
30208266
—
NH
05
—
433399099
—
ME
05
—
MD98332
—
AK
Enumeration date
10/16/2006
Last updated
11/26/2014
Update your record
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