Provider Demographics
NPI:1386684017
Name:NELSON, RICHARD S (MD)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:S
Last Name:NELSON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:18 FOUNDRY ST
Mailing Address - Street 2:SUITE 201
Mailing Address - City:CONCORD
Mailing Address - State:NH
Mailing Address - Zip Code:03301-5421
Mailing Address - Country:US
Mailing Address - Phone:603-228-0071
Mailing Address - Fax:603-227-7535
Practice Address - Street 1:18 FOUNDRY ST
Practice Address - Street 2:SUITE 201
Practice Address - City:CONCORD
Practice Address - State:NH
Practice Address - Zip Code:03301-5421
Practice Address - Country:US
Practice Address - Phone:603-228-0071
Practice Address - Fax:603-227-7535
Is Sole Proprietor?:No
Enumeration Date:2006-06-08
Last Update Date:2018-10-22
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NH9194207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NHC85726Medicare UPIN