Individual
DR. ADAM SANFORD NIELSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
250 W 300 N, ROOSEVELT, UT 84066-2351
(435) 722-4691
(435) 722-9291
Mailing address
250 W 300 N, ROOSEVELT, UT 84066-2351
(719) 282-8710
(719) 282-8710
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
10104037-1205
UT
207P00000X
Emergency Medicine Physician
MD60130455
WA
208D00000X
General Practice Physician
23355
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1790756815
—
MT
05
—
1790756815
—
WA
Enumeration date
01/27/2006
Last updated
01/29/2025
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