Provider Demographics
NPI:1033216403
Name:NELSON, CECIL ERIC (RPH)
Entity Type:Individual
Prefix:MR
First Name:CECIL
Middle Name:ERIC
Last Name:NELSON
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:205 FENDER CT
Mailing Address - Street 2:
Mailing Address - City:HAVRE DE GRACE
Mailing Address - State:MD
Mailing Address - Zip Code:21078-4109
Mailing Address - Country:US
Mailing Address - Phone:410-939-9375
Mailing Address - Fax:
Practice Address - Street 1:BUILDING 361
Practice Address - Street 2:
Practice Address - City:PERRY POINT
Practice Address - State:MD
Practice Address - Zip Code:21902-0000
Practice Address - Country:US
Practice Address - Phone:410-642-2411
Practice Address - Fax:410-642-1883
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD6974183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist