MEDICARE: DONALD J WELCH

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	156FX1800X	Optician	5579	MA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1841439916
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DONALD J WELCH

Provider Business Mailing Address
First Line	:	4199 WASHINGTON ST STE 2
Second Line	:
City	:	ROSLINDALE
State	:	MA
Zip	:	02131-1733
Country	:	US
Telephone Number	:	617-587-5520
Fax Number	:	617-587-5521

Provider Business Practice Location Address
First Line	:	4199 WASHINGTON ST STE 2
Second Line	:
City	:	ROSLINDALE
State	:	MA
Zip	:	02131-1733
Country	:	US
Telephone Number	:	617-587-5520
Fax Number	:	617-587-5521

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/13/2009
Last Update Date	:	02/13/2009

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Directions to “ DONALD J WELCH ” Practice Location

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