Nelson, Brent D
Nelson, Brent D is an individual health care provider with primary practice located at 190 E Bannock St , Boise ID 83712-6241. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Diagnostic Radiology, Allopathic & Osteopathic Physicians / Vascular & Interventional Radiology. Allopathic & Osteopathic Physicians / Vascular & Interventional Radiology is his primary health care specialty. Nelson, Brent D can be contacted via phone (208) 381-2094.Contact Information
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Diagnostic Radiology | 2085R0202X | M6231 | Idaho |
| Allopathic & Osteopathic Physicians / Vascular & Interventional Radiology | 2085R0204X | M6231 | Idaho |
Profile Details
| NPI number | 1740224310 |
|---|---|
| LBN Legal business name | Nelson, Brent D |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 15th, 2006 |
| Last updated | Oct 22nd, 2019 - about 7 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1740224310 | NPPES |
| Idaho | MEDICAID | 003858900 |
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