Provider Demographics
NPI:1366589863
Name:NELSON, SANDRA BLISS (MD)
Entity type:Individual
Prefix:DR
First Name:SANDRA
Middle Name:BLISS
Last Name:NELSON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:SANDRA
Other - Middle Name:JEANNE
Other - Last Name:BLISS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:55 FRUIT ST
Mailing Address - Street 2:MASSACHUSETTS GENERAL HOSPITAL; GRJ504
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02114-2621
Mailing Address - Country:US
Mailing Address - Phone:617-724-0082
Mailing Address - Fax:
Practice Address - Street 1:55 FRUIT ST
Practice Address - Street 2:MASSACHUSETTS GENERAL HOSPITAL; GRJ504
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02114-2621
Practice Address - Country:US
Practice Address - Phone:617-726-3816
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-31
Last Update Date:2019-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA231994207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease