Provider Demographics
NPI:1487676003
Name:NELSON, CALEB P (MD)
Entity Type:Individual
Prefix:
First Name:CALEB
Middle Name:P
Last Name:NELSON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2416 STEELE RD
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21209-3925
Mailing Address - Country:US
Mailing Address - Phone:410-955-5358
Mailing Address - Fax:
Practice Address - Street 1:149 JOHNS HOPKINS HOSPITAL MARBURG
Practice Address - Street 2:600 NORTH WOLFE STREET
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21287-0001
Practice Address - Country:US
Practice Address - Phone:410-955-5358
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-24
Last Update Date:2011-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA227359208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology