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General NPI Number Information
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NPI Number | 1508228925
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Entity Type | Individual
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Provider Name | MATTHEW WELCH MD
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Gender | Male
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Dates
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Enumeration Date | 03/24/2016
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Last Update Date | 03/04/2019
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Provider Practice Location Address
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Address Line | 2601 THOMAS DR
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City | PANAMA CITY BEACH
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State | FL
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Zip | 32408
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Country | US
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Telephone | 850-588-5835
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Fax | 850-588-5837
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Provider Business Mailing Address
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Address Line | 2601 THOMAS DR
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City | PANAMA CITY BEACH
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State | FL
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Zip | 32408-6246
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Country | US
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Telephone | 850-588-5835
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Fax | 850-588-5837
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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 | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number | ACN1130
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License Number State | FL
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