Provider Demographics
NPI:1598862203
Name:NELL, MICHAEL E (DC)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:E
Last Name:NELL
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:415 GLENSPRINGS DR STE 100
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45246-2317
Mailing Address - Country:US
Mailing Address - Phone:513-851-8686
Mailing Address - Fax:513-851-8786
Practice Address - Street 1:2847 WOODBURN AVE
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45206-1412
Practice Address - Country:US
Practice Address - Phone:513-851-8686
Practice Address - Fax:513-851-8786
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-17
Last Update Date:2023-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHOH1194111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0618540Medicaid
OH0618540Medicaid