Individual
VANCE G NIELSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
619 19TH STREET SOUTH, BIRMINGHAM, AL 35233
(205) 934-6600
Mailing address
PO BOX 55310, BIRMINGHAM, AL 35255-5310
(205) 731-9701
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
14170
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000083106
BLUE CROSS
AL
05
—
000083106
—
AL
01
—
010033CE34209
SECTION 1011
AL
01
—
01353090
MISSISSIPPI MEDICAID
MS
01
—
051511211
BLUE CROSS
AL
01
—
26595
HEALTHSPRING OF ALABAMA
AL
01
—
E34209
VIVA
AL
01
—
P00070183
RAILROAD MEDICARE
AL
Enumeration date
07/10/2006
Last updated
07/08/2007
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