Healthcare Provider Details

I. General information

NPI: 1780559674
Provider Name (Legal Business Name): AIDAN A WELSH
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/09/2025
Last Update Date: 05/27/2026
Certification Date: 05/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

55 FOGG RD
SOUTH WEYMOUTH MA
02190-2432
US

IV. Provider business mailing address

8315 N BROOK LN UNIT 1107
BETHESDA MD
20814-2653
US

V. Phone/Fax

Practice location:
  • Phone: 443-699-3462
  • Fax:
Mailing address:
  • Phone: 443-699-3462
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171000000X
TaxonomyMilitary Health Care Provider
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: