Provider Demographics
NPI:1497837132
Name:NELSON, HARRY CHARLES (MD)
Entity Type:Individual
Prefix:DR
First Name:HARRY
Middle Name:CHARLES
Last Name:NELSON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 37087
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21297-3087
Mailing Address - Country:US
Mailing Address - Phone:828-687-5616
Mailing Address - Fax:828-650-8076
Practice Address - Street 1:1021 COOLIDGE ST
Practice Address - Street 2:SUITE 2
Practice Address - City:GREENEVILLE
Practice Address - State:TN
Practice Address - Zip Code:37743-4672
Practice Address - Country:US
Practice Address - Phone:423-636-2300
Practice Address - Fax:423-636-0348
Is Sole Proprietor?:No
Enumeration Date:2006-10-20
Last Update Date:2015-06-17
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TNMD018609207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN1672216003OtherCIGNA
TN1699819003OtherGROUP NPI
TN3159941OtherBLUE CROSS
TN1497837132OtherNPI
TN3065352Medicaid
TN3159941OtherBLUE CROSS
TN1699819003OtherGROUP NPI
TNAN9231971Medicare UPIN