Provider Demographics
NPI:1912187071
Name:NIELSEN, PAUL ROBERT (MD, MS)
Entity Type:Individual
Prefix:DR
First Name:PAUL
Middle Name:ROBERT
Last Name:NIELSEN
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Gender:M
Credentials:MD, MS
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Mailing Address - Street 1:128 E MILLTOWN RD
Mailing Address - Street 2:SUITE 105
Mailing Address - City:WOOSTER
Mailing Address - State:OH
Mailing Address - Zip Code:44691-6109
Mailing Address - Country:US
Mailing Address - Phone:330-345-8060
Mailing Address - Fax:330-345-5983
Practice Address - Street 1:128 E MILLTOWN RD
Practice Address - Street 2:SUITE 105
Practice Address - City:WOOSTER
Practice Address - State:OH
Practice Address - Zip Code:44691-6109
Practice Address - Country:US
Practice Address - Phone:330-345-8060
Practice Address - Fax:330-345-5983
Is Sole Proprietor?:No
Enumeration Date:2007-11-06
Last Update Date:2010-07-15
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Provider Licenses
StateLicense IDTaxonomies
OH57-013174207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine