Healthcare Provider Details

I. General information

NPI: 1568410215
Provider Name (Legal Business Name): SCOTT R WELDEN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/05/2006
Last Update Date: 08/14/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

872 OHIO PIKE
CINCINNATI OH
45245-2204
US

IV. Provider business mailing address

872 OHIO PIKE
CINCINNATI OH
45245-2204
US

V. Phone/Fax

Practice location:
  • Phone: 513-947-8346
  • Fax: 513-752-6695
Mailing address:
  • Phone: 513-947-8346
  • Fax: 513-752-6695

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number35075182W
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code202K00000X
TaxonomyPhlebology Physician
License Number35075182
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: