Provider Demographics
NPI:1144324518
Name:NELSON, DAVID M (DC)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:M
Last Name:NELSON
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:724 W NEW YORK AVE
Mailing Address - Street 2:
Mailing Address - City:DELAND
Mailing Address - State:FL
Mailing Address - Zip Code:32720-5255
Mailing Address - Country:US
Mailing Address - Phone:386-738-0900
Mailing Address - Fax:386-738-0900
Practice Address - Street 1:724 W NEW YORK AVE
Practice Address - Street 2:
Practice Address - City:DELAND
Practice Address - State:FL
Practice Address - Zip Code:32720-5255
Practice Address - Country:US
Practice Address - Phone:386-738-0900
Practice Address - Fax:386-738-0900
Is Sole Proprietor?:No
Enumeration Date:2006-09-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH6516111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLCH6516OtherSTATE LICENSE
FLU38381Medicare UPIN
FL22823Medicare ID - Type Unspecified