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NPI Code Detail

MEDICARE: DR. BRYAN J WELLMAN MD

MEDICARE: DR. BRYAN J WELLMAN MD
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
1207T00000XNeurological Surgery Physician4984SD

General Provider Information

NPI Number : 1891776456
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. BRYAN J WELLMAN MD
Provider Business Mailing Address
First Line : PO BOX 6850
Second Line :
City : RAPID CITY
State : SD
Zip : 57709-6850
Country : US
Telephone Number : 605-341-1414
Fax Number :
Provider Business Practice Location Address
First Line : 4141 5TH ST
Second Line :
City : RAPID CITY
State : SD
Zip : 57701-6021
Country : US
Telephone Number : 605-341-1414
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/10/2005
Last Update Date : 01/17/2023

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