Healthcare Provider Details

I. General information

NPI: 1427062652
Provider Name (Legal Business Name): MICHAEL C. WELCH M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/27/2006
Last Update Date: 09/06/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

624 MCCLELLAN STREET SUITE 101
SCHNECTADY NY
12304-1020
US

IV. Provider business mailing address

624 MCCLELLAN STREET SUITE 101
SCHNECTADY NY
12304-1020
US

V. Phone/Fax

Practice location:
  • Phone: 518-382-2260
  • Fax: 518-347-5007
Mailing address:
  • Phone: 518-382-2260
  • Fax: 518-347-5007

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code173000000X
TaxonomyLegal Medicine
License Number131244-1
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number131244
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: