Individual
DR. KENNETH NELSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1000 E PARIS AVE SE, SUITE 260, GRAND RAPIDS, MI 49546-3680
(616) 957-9237
(616) 957-7913
Mailing address
1000 E PARIS AVE SE, SUITE 260, GRAND RAPIDS, MI 49546-3680
(616) 957-9237
(616) 957-7913
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
4301032782
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4191288
—
MI
Enumeration date
05/04/2006
Last updated
07/09/2007
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