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General NPI Number Information
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NPI Number | 1144206053
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Entity Type | Individual
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Provider Name | MR. GEORGE LAWRENCE WELCOME JR.
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Gender | Male
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Dates
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Enumeration Date | 12/22/2005
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Last Update Date | 08/28/2008
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Provider Practice Location Address
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Address Line | 2100 2ND ST SW SUITE 5314
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City | WASHINGTON
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State | DC
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Zip | 20593-0002
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Country | US
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Telephone | 305-953-2266
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Fax | 305-953-2308
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Provider Business Mailing Address
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Address Line | 6178 CORNING RD
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City | COCOA
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State | FL
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Zip | 32927-8861
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Country | US
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Telephone | 321-632-5529
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Fax |
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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 | 247200000X
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Taxonomy Name | Other Technician
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License Number |
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License Number State |
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