Individual
MAUREEN NELSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
2801 BAY PARK DR, OREGON, OH 43616-4920
(419) 690-7900
Mailing address
PO BOX 633390, CINCINNATI, OH 45263-3390
(800) 594-1876
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
34007795
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000260317
ANTHEM
OH
05
—
2387171
—
OH
05
—
4522424
—
MI
Enumeration date
08/17/2005
Last updated
07/13/2009
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