Individual
DR. JOHN R NELSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
400 HOBART ST, CADILLAC, MI 49601-2331
(231) 876-7200
(231) 876-6519
Mailing address
400 HOBART ST, CADILLAC, MI 49601-2331
(231) 876-7200
(231) 876-6519
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
4301072309
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
110H310180
BLUE CROSS BILLING NUMBER
MI
01
—
133381
PREF CHOICE BILLING NUMBE
MI
01
—
27544
PRIORITY HEALTH BILLING
MI
01
—
383552631103
COMMUNITY CHOICE BILLING
MI
01
—
4410114
MOLINA
MI
05
—
4410114
—
MI
Enumeration date
08/02/2005
Last updated
09/24/2008
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