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Individual

PETER J NELSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
2605 BAUMGARTNER DR, LA CROSSE, WI 54603-8503
(608) 781-1401
Mailing address
2605 BAUMGARTNER DR, LA CROSSE, WI 54603-8503
(608) 781-1401

Taxonomy

Speciality
Code
Description
License number
State
207LH0002X
Hospice and Palliative Medicine (Anesthesiology) Physician
Primary
22474-20
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
154R6NE
BLUE CROSS BLUE SHIELD
MN
01
30386200
MA
WI
05
463770400
MN
Enumeration date
07/17/2006
Last updated
08/26/2014
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