Healthcare Provider Details

I. General information

NPI: 1144864489
Provider Name (Legal Business Name): WELLDOC, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/30/2019
Last Update Date: 10/30/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10221 WINCOPIN CIR STE 150
COLUMBIA MD
21044-3444
US

IV. Provider business mailing address

10221 WINCOPIN CIR STE 150
COLUMBIA MD
21044-3444
US

V. Phone/Fax

Practice location:
  • Phone: 443-692-3100
  • Fax:
Mailing address:
  • Phone: 443-692-3100
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332900000X
TaxonomyNon-Pharmacy Dispensing Site
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code174H00000X
TaxonomyHealth Educator
License Number
License Number State

VIII. Authorized Official

Name: CAROLINE YORK
Title or Position: SVP, OPERATIONS
Credential:
Phone: 443-692-3100