Organization
ALLAN D. NELSON, M.D.
Active
Other names
Pentwater Family Practice
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ALLAN D. NELSON M.D. (OWNER)
(231) 869-7051
Entity
Organization
Contact information
Practice address
500 HANCOCK ST, PENTWATER, MI 49449-0619
(231) 869-7051
(231) 869-5536
Mailing address
PO BOX 619, 500 HANCOCK ST, PENTWATER, MI 49449-0619
(231) 869-7051
(231) 869-5536
Taxonomy
Speciality
Code
Description
License number
State
261QR1300X
Rural Health Clinic/Center
Primary
4301036682
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0640001
BLUE CROSS BLUE SHIELD
MI
05
—
2107294
—
MI
Enumeration date
05/18/2007
Last updated
07/19/2010
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