Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223S0112X | Oral and Maxillofacial Surgeon | 6819 | CO |
NPI | 1083679278 |
---|---|
Provider Name | Dr. Steven R Nelson |
First Address | Denver, CO 80224-3024 |
Second Address | Denver, CO 80224-3024 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/04/2006 |
Last Update Date | 12/07/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
U38679 | (02) | CO |