Individual
EDWARD W. NELSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2000 CIRCLE OF HOPE DR, SALT LAKE CITY, UT 84112-5550
(801) 585-0111
Mailing address
PO BOX 58049, SALT LAKE CITY, UT 84158-0049
(801) 213-3800
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
158217-1205
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003065200
—
ID
05
—
188833
—
AZ
01
—
757023028
RAILROAD MEDICARE
UT
05
—
XPY044510
—
CA
Enumeration date
10/13/2006
Last updated
11/08/2021
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