Individual
DR. MICHAEL H NIELSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3619 S DELAWARE AVE, INDEPENDENCE, MO 64055-3188
(816) 254-7310
(816) 461-2367
Mailing address
PO BOX 752, CONCORDIA, MO 64020-0752
(660) 463-1365
(660) 463-1367
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
0414225
KS
207R00000X
Internal Medicine Physician
Primary
R6157
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100446300A
—
KS
01
—
148565
COVENTRY
—
05
—
203190020
—
MO
01
—
27663024
BCBS - KC
MO
Enumeration date
04/26/2006
Last updated
07/25/2012
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