Individual
DR. KEITH G NELSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
463 E CIRCLE DR, EAST LANSING, MI 48824-7500
(517) 884-6546
(517) 432-9460
Mailing address
804 SERVICE RD, A201, EAST LANSING, MI 48824-7015
(517) 884-2976
(517) 432-3928
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
5101010456
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0100197
PHP
MI
05
—
1811001167
—
MI
05
—
4756782
—
MI
01
—
5330084
BLUE CARE NETWORK
MI
Enumeration date
08/17/2006
Last updated
06/13/2016
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