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General NPI Number Information
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NPI Number | 1134107287
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Entity Type | Individual
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Provider Name | WELLS MARTIN III M.D.
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Gender | Male
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Dates
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Enumeration Date | 01/08/2006
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Last Update Date | 09/12/2012
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Provider Practice Location Address
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Address Line | 109 MUIRS CHAPEL RD STE 100
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City | GREENSBORO
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State | NC
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Zip | 27410-6161
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Country | US
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Telephone | 336-542-2900
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Fax | 336-542-2929
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Provider Business Mailing Address
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Address Line | 1304 KENSINGTON DR
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City | HIGH POINT
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State | NC
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Zip | 27262-7318
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Country | US
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Telephone | 336-885-9211
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Fax | 336-885-9210
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 24268
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License Number State | NC
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