Provider Demographics
NPI:1699840751
Name:NELSON, DEBRA COLLEEN (MD)
Entity Type:Individual
Prefix:MS
First Name:DEBRA
Middle Name:COLLEEN
Last Name:NELSON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2222 BANCROFT WAY
Mailing Address - Street 2:TANG CENTER UHS UNIVERSITY OF CALIFORNIA BERKELEY
Mailing Address - City:BERKELEY
Mailing Address - State:CA
Mailing Address - Zip Code:94720
Mailing Address - Country:US
Mailing Address - Phone:510-643-7110
Mailing Address - Fax:510-643-2997
Practice Address - Street 1:2222 BANCROFT EXT
Practice Address - Street 2:TANG CENTER UHS UNIVERSITY OF CALIFORNIA BERKELEY
Practice Address - City:BERKELEY
Practice Address - State:CA
Practice Address - Zip Code:94720-4303
Practice Address - Country:US
Practice Address - Phone:510-643-7110
Practice Address - Fax:510-643-2997
Is Sole Proprietor?:No
Enumeration Date:2006-11-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAG50885207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine