Basic Information
| Provider Information | |||||||||
| NPI: | 1396884318 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | DAHLGREN | ||||||||
| FirstName: | NELS | ||||||||
| MiddleName: | N | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 500 WALTER ST NE | ||||||||
| Address2: | STE 213 | ||||||||
| City: | ALBUQUERQUE | ||||||||
| State: | NM | ||||||||
| PostalCode: | 871022543 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8669643795 | ||||||||
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| Practice Location | |||||||||
| Address1: | 914 PINEHURST RD SE | ||||||||
| Address2: | 102 | ||||||||
| City: | RIO RANCHO | ||||||||
| State: | NM | ||||||||
| PostalCode: | 871242219 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5058969412 | ||||||||
| FaxNumber: | 5058969416 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/06/2007 | ||||||||
| LastUpdateDate: | 02/23/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 02/23/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207LP2900X | MD2006-0838 | NM | N | Allopathic & Osteopathic Physicians | Anesthesiology | Pain Medicine | 207LP2900X | 17452 | NV | Y | Allopathic & Osteopathic Physicians | Anesthesiology | Pain Medicine |
No ID Information.