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Individual

ROBERT W. NEILSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
855 MANKATO AVE, WINONA, MN 55987-4868
(507) 454-3650
(507) 474-3392
Mailing address
855 MANKATO AVE, WINONA, MN 55987-4868
(507) 454-3650
(507) 474-3392

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
52693
MN
207R00000X
Internal Medicine Physician
L4594
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100159800A
OK
05
131010100
TX
01
131010101
FIRSTCARE COMMERCIAL
TX
05
151183401
TX
05
77871367
NM
01
78718
PRESBYTERIAN COMMERCIAL
NM
05
78718
NM
01
86723Z
HMO BLUE
TX
01
8B2602
BC/BS
TX
01
A535
TRIWEST
NM
Enumeration date
10/18/2005
Last updated
02/29/2012
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