Individual
PETER NELSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
500 LINCOLN PARK BLVD STE 110, KETTERING, OH 45429-6410
(937) 531-5020
(937) 298-4385
Mailing address
500 LINCOLN PARK BLVD STE 110, KETTERING, OH 45429-6410
(937) 531-5020
(937) 298-4385
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
17072
NH
207R00000X
Internal Medicine Physician
Primary
35.131380
OH
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0226758
—
OH
Enumeration date
05/07/2012
Last updated
11/01/2024
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