Healthcare Provider Details

I. General information

NPI: 1134547151
Provider Name (Legal Business Name): KELLEN WELCH M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/07/2014
Last Update Date: 10/08/2020
Certification Date: 10/08/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

55 ARCH ST STE 2A
AKRON OH
44304-1424
US

IV. Provider business mailing address

7107 FITCH RD
OLMSTED TWP OH
44138-1203
US

V. Phone/Fax

Practice location:
  • Phone: 330-434-5978
  • Fax: 330-434-6908
Mailing address:
  • Phone: 440-829-6432
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208C00000X
TaxonomyColon & Rectal Surgery Physician
License Number35.136434
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: