Individual
ALLAN D NELSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
500 N HANCOCK, PENTWATER, MI 49449
(231) 869-7051
(231) 869-5536
Mailing address
500 N HANCOCK, PO BOX 619, PENTWATER, MI 49449
(231) 869-7051
(231) 869-5536
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
036682
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0640001
BLUE CROSS BLUE SHIELD
MI
05
—
2107294
—
MI
Enumeration date
10/11/2006
Last updated
02/24/2021
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