Individual
JACOB RUSSELL NELSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
601 JOHN ST, KALAMAZOO, MI 49007-5341
(866) 898-7139
Mailing address
3601 W 13 MILE RD, ROYAL OAK, MI 48073-6712
(248) 898-2001
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
4351047554
MI
Other
Enumeration date
04/05/2021
Last updated
06/27/2024
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