Provider Demographics
NPI:1720155336
Name:ADAMSON, NELSON L (MD)
Entity type:Individual
Prefix:
First Name:NELSON
Middle Name:L
Last Name:ADAMSON
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 1:7401 METRO BLVD STE 210
Mailing Address - Street 2:
Mailing Address - City:EDINA
Mailing Address - State:MN
Mailing Address - Zip Code:55439-3086
Mailing Address - Country:US
Mailing Address - Phone:952-920-4915
Mailing Address - Fax:952-915-6091
Practice Address - Street 1:1475 SAINT FRANCIS AVE
Practice Address - Street 2:
Practice Address - City:SHAKOPEE
Practice Address - State:MN
Practice Address - Zip Code:55379-3301
Practice Address - Country:US
Practice Address - Phone:952-428-2663
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-29
Last Update Date:2024-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI43010772722085R0001X
MN1040232085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI920006245OtherRAILROAD MEDICARE
MI4302627Medicaid
MI320220107OtherBCBS
MI920006245OtherRAILROAD MEDICARE
C60747Medicare UPIN