Individual
DR. NELSON R. DE LARA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
26 GLEN ALPINE RD, PHOENIX, MD 21131-2404
(410) 510-7017
Mailing address
26 GLEN ALPINE RD, PHOENIX, MD 21131-2404
(410) 510-7017
Taxonomy
Speciality
Code
Description
License number
State
2085R0204X
Vascular & Interventional Radiology Physician
Primary
D16268
MD
Other
Enumeration date
04/14/2008
Last updated
04/14/2008
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