MEDICARE: WELLNESS MEDICAL SVCS PC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician

General Provider Information

NPI Number	:	1538992045
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WELLNESS MEDICAL SVCS PC

Provider Business Mailing Address
First Line	:	1427 HORSHAM RD
Second Line	:
City	:	NORTH WALES
State	:	PA
Zip	:	19454-1320
Country	:	US
Telephone Number	:	215-326-9065
Fax Number	:	215-703-9776

Provider Business Practice Location Address
First Line	:	1427 HORSHAM RD
Second Line	:
City	:	NORTH WALES
State	:	PA
Zip	:	19454-1320
Country	:	US
Telephone Number	:	215-326-9065
Fax Number	:	215-706-9776

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	KAYLY SIE
Credential	:
Telephone Number	:	215-326-9065

Provider Enumeration Date	:	08/21/2024
Last Update Date	:	03/17/2026

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