Provider Demographics
NPI:1619093143
Name:NELSON, VIKTORIYA ANATOLIYIVNA (MD)
Entity Type:Individual
Prefix:DR
First Name:VIKTORIYA
Middle Name:ANATOLIYIVNA
Last Name:NELSON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:12801 HIGHWAY 231 431 N
Mailing Address - Street 2:
Mailing Address - City:HAZEL GREEN
Mailing Address - State:AL
Mailing Address - Zip Code:35750-8629
Mailing Address - Country:US
Mailing Address - Phone:256-828-6720
Mailing Address - Fax:877-409-2907
Practice Address - Street 1:12801 HIGHWAY 231 431 N
Practice Address - Street 2:
Practice Address - City:HAZEL GREEN
Practice Address - State:AL
Practice Address - Zip Code:35750-8629
Practice Address - Country:US
Practice Address - Phone:256-828-6720
Practice Address - Fax:877-409-2907
Is Sole Proprietor?:No
Enumeration Date:2007-03-22
Last Update Date:2023-09-12
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA112122207R00000X
WI53891208M00000X
ALAL42364207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist