Individual
DR. BLAIR ALLEN NELSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3000 32ND AVE S, FARGO, ND 58103-6132
(701) 364-8000
(701) 364-8078
Mailing address
PO BOX 6001, FARGO, ND 58108-6001
(701) 364-3300
(701) 364-8906
Taxonomy
Speciality
Code
Description
License number
State
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
43550
MN
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
Primary
8757
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
11705
—
ND
05
—
190152400
—
MN
Enumeration date
10/11/2005
Last updated
08/08/2012
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