Individual
TARA NELSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
1000 HARRINGTON ST, MOUNT CLEMENS, MI 48043-2920
(586) 493-8195
Mailing address
15520 19 MILE RD STE 480, CLINTON TOWNSHIP, MI 48038-6332
(586) 228-1010
(586) 228-8570
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
5101019303
MI
207RN0300X
Nephrology Physician
Primary
5101019303
MI
Other
Enumeration date
07/14/2011
Last updated
04/06/2022
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