Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208200000X | Surgeon | 33733 | AZ |
N | 208600000X | Surgeon | 33733 | AZ |
N | 208G00000X | Cardiothoracic Vascular Surgeon | 33733 | AZ |
Y | 208G00000X | Cardiothoracic Vascular Surgeon | MD60244683 | WA |
NPI | 1093789703 |
---|---|
Provider Name | David W Nelson |
First Address | Seattle, WA 98124-3947 |
Second Address | Bellevue, WA 98004 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/02/2006 |
Last Update Date | 15/12/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
926785 | (05) | AZ |
G06372 | (02) | AZ |