Individual
ERIC M NELSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
6500 EXCELSIOR BLVD, ST LOUIS PARK, MN 55426-4702
(952) 993-3240
(952) 993-1865
Mailing address
8170 33RD AVE S # MS 21110Q, BLOOMINGTON, MN 55425-4516
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
54205
MN
207RG0100X
Gastroenterology Physician
60720
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P01034510
RAILROAD MEDICARE
MN
Enumeration date
06/16/2010
Last updated
08/03/2021
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