Provider Demographics
NPI:1982653317
Name:NELSON, CHRISTOPHER GRANT JR (MD)
Entity Type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:GRANT
Last Name:NELSON
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:350 6TH ST S
Mailing Address - Street 2:
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33701-4449
Mailing Address - Country:US
Mailing Address - Phone:727-895-8131
Mailing Address - Fax:727-821-1292
Practice Address - Street 1:350 6TH ST S
Practice Address - Street 2:
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33701-4449
Practice Address - Country:US
Practice Address - Phone:727-895-8131
Practice Address - Fax:727-821-1292
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-10
Last Update Date:2010-08-24
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
FLME9131207ND0900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ND0900XAllopathic & Osteopathic PhysiciansDermatologyDermatopathology