Provider Demographics
NPI:1598729675
Name:NELSON, SONJA N (MD)
Entity Type:Individual
Prefix:
First Name:SONJA
Middle Name:N
Last Name:NELSON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:875 GREENLAND RD
Mailing Address - Street 2:BUILDLING A-1
Mailing Address - City:PORTSMOUTH
Mailing Address - State:NH
Mailing Address - Zip Code:03801-4164
Mailing Address - Country:US
Mailing Address - Phone:603-436-1128
Mailing Address - Fax:603-431-4537
Practice Address - Street 1:875 GREENLAND RD
Practice Address - Street 2:BUILDLING A-1
Practice Address - City:PORTSMOUTH
Practice Address - State:NH
Practice Address - Zip Code:03801-4164
Practice Address - Country:US
Practice Address - Phone:603-436-1128
Practice Address - Fax:603-431-4537
Is Sole Proprietor?:No
Enumeration Date:2006-04-14
Last Update Date:2012-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH10472207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
G11758Medicare UPIN