Healthcare Provider Details

I. General information

NPI: 1578596409
Provider Name (Legal Business Name): DAVID ANDREW WELLMAN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/07/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1505 COMMONWEALTH AVE
BRIGHTON MA
02135-3605
US

IV. Provider business mailing address

300 ROSEWOOD DR SUITE 104
DANVERS MA
01923-1389
US

V. Phone/Fax

Practice location:
  • Phone: 617-783-1441
  • Fax: 617-783-1448
Mailing address:
  • Phone: 978-774-7243
  • Fax: 978-774-7421

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number207966
License Number StateMA
# 2
Primary TaxonomyY
Taxonomy Code207RS0012X
TaxonomySleep Medicine (Internal Medicine) Physician
License Number207966
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: