Provider Demographics
NPI:1003848664
Name:NELSON, DAVID MONROE (MD)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:MONROE
Last Name:NELSON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:113 CHANCERY LN
Mailing Address - Street 2:
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31410-3198
Mailing Address - Country:US
Mailing Address - Phone:912-897-1702
Mailing Address - Fax:912-352-4053
Practice Address - Street 1:138 CANAL ST STE 201
Practice Address - Street 2:
Practice Address - City:POOLER
Practice Address - State:GA
Practice Address - Zip Code:31322-4047
Practice Address - Country:US
Practice Address - Phone:912-348-3833
Practice Address - Fax:912-348-2669
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-06
Last Update Date:2025-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA31085207QA0401X, 207QB0002X, 208D00000X, 208VP0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain Medicine
No207QA0401XAllopathic & Osteopathic PhysiciansFamily MedicineAddiction Medicine
No207QB0002XAllopathic & Osteopathic PhysiciansFamily MedicineObesity Medicine
No208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA000466573BMedicaid
GA01BDDZLMedicare ID - Type UnspecifiedFAMILY PRACTICE