Individual
FREDRIC NELSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
5000 WOODLAND AVE, PHILA, PA 19143-5137
(215) 726-9807
Mailing address
432 N 6TH ST, PHILA, PA 19123-4004
(215) 925-2400
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
MD021942
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
006616900
—
PA
Enumeration date
06/08/2006
Last updated
03/04/2010
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