Healthcare Provider Details

I. General information

NPI: 1275889834
Provider Name (Legal Business Name): KERRY J WELSH MD, PHD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/31/2012
Last Update Date: 02/26/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10 CENTER DR BUILDING 10, RM 2C306
BETHESDA MD
20814
US

IV. Provider business mailing address

10 CENTER DR BUILDING 10, RM 2C306
BETHESDA MD
20814
US

V. Phone/Fax

Practice location:
  • Phone: 301-496-3386
  • Fax:
Mailing address:
  • Phone: 301-496-3386
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207ZC0006X
TaxonomyClinical Pathology Physician
License NumberD0079204
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: