Individual
DR. MICHAEL J NELSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2800 CLAY EDWARDS DR, NORTH KANSAS CITY, MO 64116-3220
(816) 346-7220
(816) 346-7242
Mailing address
PO BOX 11157, KANSAS CITY, MO 64119-0157
(913) 234-1350
(913) 234-1108
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
R8N03
MO
207PE0005X
Undersea and Hyperbaric Medicine (Emergency Medicine) Physician
Primary
R8N03
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
19133017
BCBS KC MO
MO
01
—
19133027
BCBS KC MO WOUND CARE
MO
05
—
202930913
—
MO
01
—
930016992
RR MEDICARE GROUP CD1534
—
01
—
P00604070
RR MEDICARE GROUP DN0988
MO
Enumeration date
08/30/2005
Last updated
07/31/2008
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