Individual
DR. ROBERT C NELSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PSYD
Contact information
Practice address
5617 MAXWELL PL, WILMINGTON, NC 28409-2966
(910) 742-9243
(888) 746-1787
Mailing address
PO BOX 16310, WILMINGTON, NC 28408-6310
(910) 742-9243
(888) 746-1787
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
1210
SC
2084P0800X
Psychiatry Physician
RPS2002005
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
301100
—
SC
01
—
P01126706
RR MEDICARE
SC
05
—
PS0511
—
SC
Enumeration date
10/04/2006
Last updated
09/22/2013
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