Healthcare Provider Details

I. General information

NPI: 1861469413
Provider Name (Legal Business Name): JAMES M WELLS MD
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 03/02/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7113 THREE CHOPT RD SUITE 101
RICHMOND VA
23226-3643
US

IV. Provider business mailing address

7113 THREE CHOPT RD SUITE 101
RICHMOND VA
23226-3643
US

V. Phone/Fax

Practice location:
  • Phone: 804-282-4205
  • Fax: 804-673-6432
Mailing address:
  • Phone: 804-282-4205
  • Fax: 804-673-6432

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number0101019978
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: