Individual
DAVID B NIELSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1055 N 300 W STE 104, PROVO, UT 84604-3344
(801) 225-6246
(801) 225-1525
Mailing address
PO BOX 837, CORVALLIS, OR 97339-0837
(541) 758-5047
(541) 758-3713
Taxonomy
Speciality
Code
Description
License number
State
2085P0229X
Pediatric Radiology Physician
04-33446
KS
2085P0229X
Pediatric Radiology Physician
11765834-1205
UT
2085P0229X
Pediatric Radiology Physician
2008036902
MO
2085R0202X
Diagnostic Radiology Physician
Primary
11765834-1205
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1649383027
—
UT
Enumeration date
08/17/2006
Last updated
11/20/2024
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