Individual
DR. MATTHEW PAUL NELSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
800 RIVERSIDE DR, WAUPACA, WI 54981-1943
(715) 258-1000
Mailing address
3 NEENAH CTR, NEENAH, WI 54956-3070
(715) 258-1000
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
57397-21
WI
207P00000X
Emergency Medicine Physician
OS013189
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
001753894
BLUE SHIELD
PA
05
—
1013578200005
—
PA
01
—
P00409100
RAILROAD MEDICARE
PA
01
—
P01099948
MEDICARE RAILROAD
WI
Enumeration date
05/17/2006
Last updated
05/05/2022
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