Healthcare Provider Details

I. General information

NPI: 1750503140
Provider Name (Legal Business Name): MARTHA C WELCH MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/03/2007
Last Update Date: 09/19/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1711 E ARLINGTON BLVD PHYSICIANS EAST, P.A.
GREENVILLE NC
27858-5872
US

IV. Provider business mailing address

1850 W ARLINGTON BLVD PHYSICIANS EAST
GREENVILLE NC
27834-5704
US

V. Phone/Fax

Practice location:
  • Phone: 252-355-4357
  • Fax: 252-355-4187
Mailing address:
  • Phone: 252-413-6740
  • Fax: 252-413-6740

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QA0505X
TaxonomyAdult Medicine Physician
License Number2009-01583
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: