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Individual

DR. STEPHEN M NILSEN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.O.

Contact information

Practice address
8100 SANDPIPER CIR STE 210, NOTTINGHAM, MD 21236-4992
(855) 527-7246
(866) 229-5063
Mailing address
28665 EARTHLITE RD, WYE MILLS, MD 21679-2024
(410) 827-7188
(410) 827-7076

Taxonomy

Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
DO33153
DC
207L00000X
Anesthesiology Physician
Primary
H0058012
MD

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
699474101
MD
Enumeration date
12/17/2005
Last updated
06/24/2024
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