Provider Demographics
NPI:1043477136
Name:NELSON, MICHAEL AARON (MD)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:AARON
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 1:7751 WOLF RIVER BLVD
Mailing Address - Street 2:
Mailing Address - City:GERMANTOWN
Mailing Address - State:TN
Mailing Address - Zip Code:38138-1706
Mailing Address - Country:US
Mailing Address - Phone:901-297-4000
Mailing Address - Fax:901-531-8344
Practice Address - Street 1:7751 WOLF RIVER BLVD
Practice Address - Street 2:
Practice Address - City:GERMANTOWN
Practice Address - State:TN
Practice Address - Zip Code:38138-1706
Practice Address - Country:US
Practice Address - Phone:901-297-4000
Practice Address - Fax:901-531-8344
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-17
Last Update Date:2012-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN43656207RC0000X, 207RI0011X, 207UN0901X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
No207UN0901XAllopathic & Osteopathic PhysiciansNuclear MedicineNuclear Cardiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN1509991Medicaid
TN1509991Medicaid